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全科医生对卫生政策变化的看法:对英国全科医学在线杂志评论的定性“网络民族志”研究。

GPs' views of health policy changes: a qualitative 'netnography' study of UK general practice online magazine commentary.

机构信息

Centre for Primary Care.

Health Services Research Centre at Alliance Manchester Business School, University of Manchester, Manchester.

出版信息

Br J Gen Pract. 2018 Jun;68(671):e441-e448. doi: 10.3399/bjgp18X696161. Epub 2018 Apr 23.

Abstract

BACKGROUND

Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs' autonomy and improve access to care. Meanwhile, GPs' levels of job satisfaction are low, while stress levels are high. is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice.

AIM

To analyse readers' reactions to news stories about health policy changes published in an online general practice magazine.

DESIGN AND SETTING

A qualitative 'netnography' was undertaken of readers' comments to METHOD: A sample of readers' comments on articles published in was collated and subjected to thematic analysis.

RESULTS

Around 300 comments on articles published between January 2012 and March 2016 were included in the analysis, using 'access to care' as a tracer theme. Concern about the demand and strain on general practice was perhaps to be expected. However, analysis revealed various dimensions to this concern: GPs' underlying feelings about their work and place in the NHS; constraints to GPs' control of their own working practices; a perceived loss of respect for the role of GP; and disappointment with representative bodies and GP leadership.

CONCLUSION

This study shows a complex mix of resistance and resignation in general practice about the changing character of GPs' roles. This ambivalence deserves further attention because it could potentially shape responses to further change in primary care in ways that are as yet unknown.

摘要

背景

自 2010 年以来,卫生政策的转变给英国国民保健制度带来了重大的结构变化,政府表示有意增加全科医生的自主权并改善医疗服务的可及性。与此同时,全科医生的工作满意度较低,而压力水平较高。 is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. 是一家受欢迎的英国全科医生在线杂志,为与全科医生相关的新闻提供了一个重要的讨论论坛。

目的

分析读者对在线全科医学杂志上发表的有关卫生政策变化的新闻报道的反应。

设计与设置

对读者对在线全科医学杂志上发表的新闻报道的反应进行了定性的“网络民族志”分析。

方法

对 2012 年 1 月至 2016 年 3 月期间发表的文章的读者评论进行了抽样收集,并进行了主题分析。

结果

在分析中使用“医疗服务可及性”作为追踪主题,共纳入了约 300 条对 2012 年 1 月至 2016 年 3 月期间发表的文章的评论。对普通科医生工作和在国民保健制度中的地位的不满,对普通科医生对自身工作实践的控制的限制,对医生角色的尊重的丧失,以及对代表机构和普通科医生领导的失望。

结论

这项研究表明,普通科医生对全科医生角色变化的态度是复杂的,既有抵制也有顺从。这种矛盾心理值得进一步关注,因为它可能会以目前未知的方式影响人们对初级保健进一步变革的反应。

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