Björk Joar, Stenfors Terese, Juth Niklas, Gunnarsson A Birgitta
Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Stockholm, Sweden.
Department of Research and Development, Region Kronoberg, Växjö, Sweden.
Scand J Prim Health Care. 2021 Sep;39(3):322-331. doi: 10.1080/02813432.2021.1935048. Epub 2021 Jun 15.
To analyse and describe general practitioners' perceptions of the notion of a 'personal responsibility for health'.
Interview study, phenomenographic analysis.
Swedish primary health care.
General Practitioners (GPs).
Using the phenomenographic method, the different views of the phenomenon (here: personal responsibility for health) were presented in an outcome space to illustrate the range of perceptions.
The participants found the notion of personal responsibility for health relevant to their practice. There was a wide range of perceptions regarding the of this responsibility, which was seen as coming from within yourself; from your relationships to specific others; and/or from your relationship with the generalized other. Furthermore, the of this responsibility were perceived as including owning your health problem; not offloading all responsibility onto the GP; taking active measures to keep and improve health; and/or accepting help in health. The GP was described as playing a key role in shaping and defining the patient's responsibility for his/her health. Some aspects of personal responsibility for health roused strong emotions in the participants, especially situations where the patient was seen as offloading all responsibility onto the GP.
The notion of personal responsibility for health is relevant to GPs. However, it is open to a broad range of interpretations and modulated by the patient-physician interaction. This may make it unsuitable for usage in health care priority settings. More research is mandated to further investigate how physicians work with patient responsibility, and how this affects the patient-physician relationship and the physician's own well-being.Key PointsThe notion of personal responsibility for health has relevance for discussions about priority setting and person-centred care.This study, using a phenomenographic approach, investigated the views of Swedish GPs about the notion of personal responsibility for health.The participants found the notion relevant to their practice. They expressed a broad range of views of what a personal responsibility for health entails and how it arises. The GP was described as playing a key role in shaping and defining the patient's responsibilities for his/her health.The notion was emotionally charged to the participants, and when patients were seen as offloading all responsibility onto the GP this gave rise to frustration.
分析并描述全科医生对“个人健康责任”这一概念的看法。
访谈研究，现象学分析。
瑞典初级卫生保健。
全科医生（GPs）。
运用现象学方法，在一个结果空间中呈现该现象（此处为个人健康责任）的不同观点，以说明认知范围。
参与者发现个人健康责任这一概念与他们的实践相关。对于这种责任的来源存在广泛的认知，责任被视为来自自身；来自与特定他人的关系；和/或来自与广义他人的关系。此外，这种责任的方面被认为包括对自身健康问题负责；不将所有责任都推给全科医生；采取积极措施保持和改善健康；和/或接受健康方面的帮助。全科医生被描述为在塑造和界定患者对其自身健康的责任方面发挥关键作用。个人健康责任的某些方面在参与者中引发了强烈情绪，特别是当患者被视为将所有责任都推给全科医生的情况。
个人健康责任这一概念与全科医生相关。然而，它存在广泛的解释空间，并受到医患互动的调节。这可能使其不适用于卫生保健优先事项设定。需要更多研究进一步调查医生如何处理患者责任，以及这如何影响医患关系和医生自身的幸福感。
关键点
个人健康责任这一概念与关于优先事项设定和以患者为中心的护理的讨论相关。
本研究采用现象学方法，调查了瑞典全科医生对个人健康责任概念的看法。
参与者发现该概念与他们的实践相关。他们对个人健康责任的内涵以及责任如何产生表达了广泛的观点。全科医生被描述为在塑造和界定患者对其自身健康的责任方面发挥关键作用。
该概念在参与者中引发了情绪反应，当患者被视为将所有责任都推给全科医生时，会导致沮丧情绪。
