J Emerg Nurs. 2020 Mar;46(2):163-170. doi: 10.1016/j.jen.2019.08.007. Epub 2019 Nov 2.
Despite the plethora of research on the use of emergency department services for nonurgent primary health care, the vast majority of this research is quantitative in nature. To date, there is little research that reports on the problem from the patients' perspective and/or lived experience, which compromises health care providers' understanding of the essence of the problem as described by the patients. Thus, this study will provide a qualitative description of nonurgent ED visits from the patients' perspective. Specifically, this study answers the following research questions: 1) What are the reasons for patients and/or caregivers visiting the emergency department for nonurgent health conditions? and 2) What are the barriers experienced by patients and/or caregivers when seeking access to health care?
A qualitative descriptive design with face-to-face interviews of 33 consenting participants was conducted at 4 emergency departments. All interviewed participants were triaged as nonurgent patients by the ED personnel.
Three themes surfaced from the data regarding reasons for using the emergency department: 1) Practitioner referral; 2) Efficacy of care; and 3) Time saver. When describing barriers that participants experienced when seeking care outside of the emergency department for their nonurgent conditions, 3 themes that emerged are lack of primary care provider, financial difficulties, and lack of comprehensive care outside the emergency department.
The results of the study can help inform patient-centered care and future policy initiatives that will address the practices and barriers contributing to nonurgent ED visits.
尽管有大量关于在急诊部门提供非紧急基本医疗保健的研究,但其中绝大多数是定量研究。迄今为止,很少有研究从患者的角度和/或亲身体验报告该问题,这影响了医疗保健提供者对患者所描述问题本质的理解。因此,本研究将从患者的角度对非紧急急诊就诊进行定性描述。具体而言,本研究回答了以下研究问题:1)患者和/或照顾者为何因非紧急健康状况前往急诊室?2)患者和/或照顾者在寻求医疗保健时遇到哪些障碍?
在 4 家急诊室进行了面对面访谈的定性描述性设计,共纳入了 33 名同意参加的参与者。所有接受采访的参与者均被急诊室工作人员分诊为非紧急患者。
关于使用急诊室的原因,有 3 个主题从数据中浮现出来:1)医生转介;2)治疗效果;3)节省时间。当描述参与者在非紧急情况下寻求急诊室以外的医疗服务时遇到的障碍时,出现了 3 个主题:1)缺乏初级保健提供者;2)经济困难;3)急诊室以外缺乏全面的医疗服务。
该研究结果可以帮助提供以患者为中心的护理,并为未来的政策举措提供信息,以解决导致非紧急急诊就诊的实践和障碍。