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马来西亚初级保健医生管理慢性下腰痛患者的观点和经验:一项定性研究

The views and experiences of Malaysian primary care doctors in managing patients with chronic low back pain: a qualitative study.

作者信息

Hani S S, Liew S M

机构信息

MBBChBAO, MFamMed Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, UPM Serdang, Malaysia. E-mail:

MBBS, MMED, DPhil, Department of Primary Care Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia. Email:

出版信息

Malays Fam Physician. 2018 Apr 30;13(1):18-27. eCollection 2018.

Abstract

BACKGROUND

Chronic low back pain (CLBP) is a common and often difficult to treat condition in the primary care setting. Research involving in-depth exploration on the views and experiences faced by primary care doctors in managing patients with CLBP in Malaysia is limited.

OBJECTIVE

To explore the primary care practitioners' views and experiences in managing patients with CLBP.

STUDY DESIGN

A qualitative approach was employed using focus group discussions (FGD) at an academic primary care clinic in Kuala Lumpur, Malaysia. Twenty-three primary care doctors were purposively selected. Data were collected through audio-recorded interviews, which were transcribed verbatim and checked for accuracy. Data saturation was reached by the third FGD. An additional FGD was included to ensure completeness. A thematic approach using the one sheet of paper (OSOP) method was used to analyse the data.

RESULTS

Participants view managing patients with CLBP as challenging. This is mainly due to the difficulty in balancing the doctors' expectations with the patients' perceived expectations during consultation. Barriers identified include lack of awareness and conflicting views regarding the usefulness of the local clinical practice guideline (CPG) in clinical practice. Other barriers include time constraints and perceived lack of support from multidisciplinary teams in managing these patients.

CONCLUSION

Managing patients with CLBP is still a challenge for Malaysian primary care doctors. Any intervention should target identified barriers to improve the management of patients with CLBP.

摘要

背景

慢性下腰痛(CLBP)在基层医疗环境中是一种常见且往往难以治疗的病症。在马来西亚,针对基层医疗医生在管理CLBP患者过程中所面临的观点和经历进行深入探索的研究有限。

目的

探讨基层医疗从业者在管理CLBP患者方面的观点和经历。

研究设计

采用定性研究方法,在马来西亚吉隆坡的一家学术基层医疗诊所进行焦点小组讨论(FGD)。目的选取了23名基层医疗医生。通过录音访谈收集数据,逐字转录并检查准确性。第三个焦点小组讨论达到了数据饱和。增加了一个焦点小组讨论以确保完整性。使用单页纸(OSOP)方法的主题分析法对数据进行分析。

结果

参与者认为管理CLBP患者具有挑战性。这主要是由于在会诊期间难以平衡医生的期望与患者的感知期望。确定的障碍包括对当地临床实践指南(CPG)在临床实践中的有用性缺乏认识和存在相互矛盾的观点。其他障碍包括时间限制以及在管理这些患者方面认为缺乏多学科团队的支持。

结论

对于马来西亚基层医疗医生而言,管理CLBP患者仍然是一项挑战。任何干预措施都应针对已确定的障碍,以改善CLBP患者的管理。

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