“总是给他们扑热息痛，他们什么病都用扑热息痛治疗”：一项定性研究，考察东欧移民对英国医疗服务的体验。
"Always paracetamol, they give them paracetamol for everything": a qualitative study examining Eastern European migrants' experiences of the UK health service.
机构信息
Public Health Institute, Liverpool John Moores University, Liverpool, UK.
出版信息
BMC Health Serv Res. 2017 Aug 29;17(1):604. doi: 10.1186/s12913-017-2526-3.
BACKGROUND
The enlargement of the European Union since 2004 has led to an increase in the number of Eastern European migrants living in the UK. The health of this group is under-researched though some mixed evidence shows they are at higher risk of certain physical health conditions such as heart attacks, strokes, HIV and alcohol use and have poorer mental health. This is compounded by poor or insecure housing, low pay, isolation and prejudice. We aimed to understand the health needs and health service experiences of the Eastern European population in a town in Northern England.
METHODS
Five semi structured one-to-one and small group interviews and five focus groups were conducted with 42 Eastern European participants between June and September 2014. The majority of participants were Polish and other participants were from Belarus, Hungary, Latvia, Russia, Slovakia and Ukraine. The data were analysed using thematic framework analysis.
RESULTS
Key findings included a good understanding the UK health service structure and high registration and use of general practice/primary care services. However, overall, there were high levels of dissatisfaction, frustration and distrust in General Practitioners (GP). The majority of participants viewed the GP as unhelpful and dismissive; a barrier to secondary/acute care; reluctant to prescribe antibiotics; and that GPs too often advised them to take paracetamol (acetaminophen) and rest.
CONCLUSIONS
Overwhelmingly participants had strong opinions about access to primary care and the role of the general practitioners. Although the design of the UK health service was well understood, participants were unhappy with the system of GP as gatekeeper and felt it inferior to the consumer-focused health systems in their country of origin. More work is needed to promote the importance of self-care, reduce antibiotic and medication use, and to increase trust in the GP.
背景
自 2004 年以来，欧盟的扩大导致居住在英国的东欧移民人数增加。尽管有一些混合证据表明，他们患某些身体健康状况（如心脏病发作、中风、艾滋病毒和酗酒）的风险更高，心理健康状况更差，但这一群体的健康状况却没有得到充分研究。这是由于住房条件差或不稳定、低工资、孤立和偏见造成的。我们的目的是了解英格兰北部一个城镇的东欧人口的健康需求和卫生服务体验。
方法
2014 年 6 月至 9 月期间，我们对 42 名东欧参与者进行了五次半结构式一对一和小组访谈以及五次焦点小组访谈。大多数参与者是波兰人，其他参与者来自白俄罗斯、匈牙利、拉脱维亚、俄罗斯、斯洛伐克和乌克兰。使用主题框架分析对数据进行了分析。
结果
主要发现包括对英国卫生服务结构的良好理解，以及普遍注册和使用普通科/初级保健服务。然而，总体而言，对全科医生（GP）的不满、沮丧和不信任程度很高。大多数参与者认为 GP 不帮忙、不重视；是进入二级/急性护理的障碍；不愿意开抗生素；而且 GP 经常建议他们服用扑热息痛（对乙酰氨基酚）和休息。
结论
参与者对获得初级保健和全科医生的作用的看法压倒性地强烈。尽管英国卫生服务的设计得到了很好的理解，但参与者对 GP 作为守门人的制度感到不满，并认为它不如原籍国以消费者为中心的卫生系统。需要做更多的工作来促进自我保健的重要性，减少抗生素和药物的使用，并增加对全科医生的信任。
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