School of Public Health and Social Work, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia.
School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia.
Emerg Med Australas. 2022 Jun;34(3):376-384. doi: 10.1111/1742-6723.13903. Epub 2021 Nov 17.
Demand for ED care is increasing at a rate higher than population growth. Strategies to attenuate ED demands include diverting low-acuity general practice-type ED attendees to alternate primary healthcare settings. The present study assessed the ED attendees' receptiveness to accept triage nurse's face-to-face advice to explore alternate options for medical care and what factors influence the level of acceptance.
The ED attendees of four major public hospital EDs in Brisbane were surveyed between August and October 2018, using a questionnaire informed by Health Belief Model's cues to action.
Of the 514 valid responses, 81% of respondents were very likely/likely to accept the triage nurse's advice to see a general practitioner. Self-perceived urgency of presenting condition/s (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.78-0.97), not having confidence in general practitioner (OR 0.37, 95% CI 0.21-0.66) and having a medical record at the hospital (OR 0.60, 95% CI 0.36-0.99) were negatively associated with the likelihood of accepting the advice. For every point increase in perceived seriousness, the odds of accepting the advice decreased by 16% (95% CI 6-25%).
Most of the participants believed that EDs were for emergent care and they attended the ED because they perceived their presenting condition/s to be serious and/or urgent. The acceptability of face-to-face advice by triage nurse to seek help in general practice was influenced by perceived threats of the illness, and the underlying beliefs about availability, accessibility, suitability and affordability of the service.
急诊科就诊需求的增长速度高于人口增长速度。减轻急诊科需求的策略包括将低危普通科型急诊科就诊者分流至其他初级保健医疗机构。本研究评估了急诊科就诊者接受分诊护士面对面建议,以探索其他医疗选择的意愿,以及哪些因素影响接受程度。
2018 年 8 月至 10 月期间,对布里斯班 4 家主要公立医院急诊科的就诊者进行了问卷调查,该问卷的设计依据健康信念模型的促发因素。
在 514 份有效回复中,81%的受访者非常可能/可能会接受分诊护士的建议去看全科医生。自我感知就诊情况的紧迫性(比值比 [OR] 0.87,95%置信区间 [CI] 0.78-0.97)、对全科医生缺乏信心(OR 0.37,95% CI 0.21-0.66)和在医院有病历(OR 0.60,95% CI 0.36-0.99)与接受建议的可能性呈负相关。感知严重性每增加 1 分,接受建议的可能性就降低 16%(95% CI 6-25%)。
大多数参与者认为急诊科是用于紧急护理的,他们来急诊科就诊是因为他们认为自己的就诊情况严重且/或紧急。分诊护士提供的面对面建议寻求全科医生帮助的可接受性受到对疾病威胁的感知的影响,以及对服务的可及性、适用性、适宜性和可负担性的潜在信念的影响。