Loignon Christine, Gottin Thomas, Dupéré Sophie, Bedos Christophe
Faculty of Medicine, Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada.
Faculty of Nursing, Université Laval, Québec, Canada.
Fam Pract. 2018 Jan 16;35(1):105-110. doi: 10.1093/fampra/cmx078.
Social inequalities in healthcare systems persist worldwide. Physicians' prejudices and negative attitudes towards people living in poverty are one of the determinants of healthcare inequalities. We know very little about general practitioners' (GPs) perceptions of poverty, which shape their attitudes.
To identify the perceptions of poverty of GPs who deal with it in everyday practice.
A qualitative study based on interviews with GPs working in deprived urban neighbourhoods. In-depth semi-structured interviews were conducted with physicians working in disadvantaged neighbourhoods in Montreal, Canada. Interviews were audio-recorded and transcribed verbatim. Analysis consisted of interview debriefing, transcript coding, and thematic analysis using an inductive and iterative approach.
Our study revealed two contrasting perceptions of poverty. The global conception of poverty referred to social determinants and was shared by the majority of physicians interviewed, while the moral conception, centring on individual responsibility, was shared by a minority of participants.
The moral judgments and misunderstandings evidenced by GPs regarding poverty suggest avenues for improving general medical training. Understanding social determinants of health should be an important component of this training, to improve access to care for people living in poverty.
医疗保健系统中的社会不平等在全球范围内持续存在。医生对贫困人口的偏见和消极态度是医疗保健不平等的决定因素之一。我们对全科医生（GP）对贫困的看法知之甚少，而这些看法塑造了他们的态度。
确定在日常实践中接触贫困问题的全科医生对贫困的看法。
一项基于对在贫困城市社区工作的全科医生进行访谈的定性研究。对在加拿大蒙特利尔贫困社区工作的医生进行了深入的半结构化访谈。访谈进行了录音并逐字转录。分析包括访谈汇报、转录编码以及采用归纳和迭代方法的主题分析。
我们的研究揭示了两种截然不同的贫困观念。贫困的整体观念涉及社会决定因素，大多数接受访谈的医生都认同这一点，而以个人责任为核心的道德观念则只有少数参与者认同。
全科医生对贫困表现出的道德判断和误解为改进普通医学培训指明了方向。了解健康的社会决定因素应成为该培训的重要组成部分，以改善贫困人口获得医疗服务的机会。
