School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.
Institute of Health Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China.
Int J Health Plann Manage. 2021 May;36(3):847-865. doi: 10.1002/hpm.3134. Epub 2021 Feb 21.
This study is designed to present out-patient's 'inappropriate diagnosed seeking behaviour' in tertiary hospitals and interpret its association with some potential social factors.
A qualitative study based on grounded theory was designed in this paper. The participates were recruited by a two-stage process. The field observation and in-depth interview were adopted for data collection. Multi-round (five rounds) sampling and continuing data analysis were adopted as well.
Totally 26 out-patients from three tertiary hospitals in Shanghai were involved. Four focused codes, including 'limited policy-related knowledge', 'limited health-related knowledge', 'distrust on related policy' and 'distrust on medical networks', were identified. Then, a theoretical model about the association of out-patient's 'limited knowledge' with 'distrust' and its relationship with 'inappropriate first-diagnosed seeking behaviour' in tertiary hospitals was developed.
'Inappropriate first-diagnosed seeking behaviour' of the out-patients in tertiary hospitals is closely associated with their limited knowledge and related distrust. Great effort on improving publics' knowledge and rebuilding a benign trust relationship with out-patients and the medical networks is found to be essential for guiding publics' appropriate first-diagnosed health behaviour in various levels of medical institutions.
本研究旨在呈现三级医院门诊患者“不当首诊寻求行为”,并阐释其与某些潜在社会因素的关联。
本研究采用基于扎根理论的定性研究设计。参与者通过两阶段过程招募。采用现场观察和深入访谈进行数据收集。采用多轮(五轮)抽样和持续数据分析。
共纳入来自上海 3 家三级医院的 26 名门诊患者。确定了 4 个聚焦码,包括“有限的政策相关知识”、“有限的健康相关知识”、“对相关政策的不信任”和“对医疗网络的不信任”。然后,构建了一个关于门诊患者“有限知识”与“不信任”及其与三级医院“不当首诊寻求行为”之间关联的理论模型。
三级医院门诊患者的“不当首诊寻求行为”与其有限的知识和相关的不信任密切相关。努力提高公众的知识水平,重建与门诊患者和医疗网络的良性信任关系,对于引导公众在各级医疗机构中进行适当的首诊健康行为至关重要。