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城市基层医疗机构门急诊急性上呼吸道感染的医疗管理:患者就诊情况和预期的横断面研究。

Medical management of acute upper respiratory infections in an urban primary care out-of-hours facility: cross-sectional study of patient presentations and expectations.

机构信息

Graduate Entry Medical School, University of Limerick Faculty of Education and Health Sciences, Limerick, Ireland.

Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland.

出版信息

BMJ Open. 2019 Feb 15;9(2):e025396. doi: 10.1136/bmjopen-2018-025396.

DOI:10.1136/bmjopen-2018-025396
PMID:30772860
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6398638/
Abstract

OBJECTIVES

The purpose of this study was to examine the expectations of patients attending an urban primary care out-of-hours (OOH) facility with acute upper respiratory tract infection (acute URTI) regarding clinical examination, symptom management, information on their condition, reassurance, antibiotic treatment and other possible options including referral.

DESIGN

Cross-sectional design.

SETTING

One urban primary care OOH facility located in the midwest of Ireland.

PARTICIPANTS

457 patients filled out a questionnaire while waiting in the OOH facility; 22 surveys were excluded as the patients did not present with symptoms of acute URTI resulting in 435 patients' data being included in this study. There were 59.5% female participants and 40.5% male participants.

RESULTS

435 patients with acute URTI symptoms participated in the survey, representing 25.4% of those attending the single branch where the survey was conducted (n=1715). Of the study participants, 43% were aged under 6 years and 60% were women. The most common presenting symptoms were cough (72%), throat ache (46%) and common cold (26%). The most common expectations were for further examination (53%), reassurance (51%), information (49%) and medication for cough (47%), with 34% expecting an antibiotic.

CONCLUSIONS

Only one in three patients attending this primary care OOH facility with acute URTI symptoms had an expectation of antibiotics, with most seeking further assessment, information and reassurance. Recognition of such expectations may be important considerations for clinicians when deciding on management options for patients with acute URTI.

摘要

目的

本研究旨在调查患有急性上呼吸道感染(acute URTI)的患者在城市基层医疗保健机构的非工作时间(out-of-hours,OOH)就诊时对临床检查、症状管理、病情信息、安抚、抗生素治疗以及其他可能的选择(包括转诊)的期望。

设计

横断面设计。

地点

爱尔兰中西部的一个城市基层医疗保健 OOH 机构。

参与者

457 名患者在 OOH 机构等候时填写了一份问卷;22 份问卷因患者未出现急性 URTI 症状而被排除在外,因此有 435 名患者的数据被纳入本研究。参与者中女性占 59.5%,男性占 40.5%。

结果

435 名患有急性 URTI 症状的患者参与了调查,占参与该调查的单一分支机构(n=1715)的 25.4%。在研究参与者中,43%的人年龄在 6 岁以下,60%的人为女性。最常见的症状是咳嗽(72%)、喉咙痛(46%)和普通感冒(26%)。最常见的期望是进一步检查(53%)、安抚(51%)、信息(49%)和咳嗽药物治疗(47%),34%的人期望使用抗生素。

结论

只有三分之一的急性 URTI 症状患者在这家基层医疗保健 OOH 机构就诊时期望使用抗生素,大多数人寻求进一步评估、信息和安抚。当为急性 URTI 患者决定管理方案时,认识到这些期望可能是临床医生的重要考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e61/6398638/ab362f7a960c/bmjopen-2018-025396f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e61/6398638/ab362f7a960c/bmjopen-2018-025396f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e61/6398638/ab362f7a960c/bmjopen-2018-025396f01.jpg

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