澳大利亚全科医生对阻塞性睡眠呼吸暂停的评估、转诊和管理：定性分析。
Assessment, referral and management of obstructive sleep apnea by Australian general practitioners: a qualitative analysis.
机构信息
National Centre for Sleep Health Services Research, Bedford Park, SA, Australia.
FHMRI Sleep/Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Box 6, Mark Oliphant Building, 5 Laffer Drive, Bedford Park, SA, Australia.
出版信息
BMC Health Serv Res. 2021 Nov 18;21(1):1248. doi: 10.1186/s12913-021-07274-7.
BACKGROUND
The high and increasing demand for obstructive sleep apnea (OSA) care has exceeded the capacity of specialist sleep services prompting consideration of whether general practitioners could have an enhanced role in service delivery. However, little is known about the current involvement, experiences and attitudes of Australian general practitioners towards OSA. The purpose of this study was to provide an in-depth analysis of Australian general practitioners' experiences and opinions regarding their care of patients with OSA to inform the design and implementation of new general practice models of care.
METHODS
Purposive sampling was used to recruit participants with maximum variation in age, experience and location. Semi-structured interviews were conducted and were analysed using Thematic Analysis.
RESULTS
Three major themes were identified: (1) General practitioners are important in recognising symptoms of OSA and facilitating a diagnosis by others; (2) Inequities in access to the assessment and management of OSA; and (3) General practitioners currently have a limited role in the management of OSA.
CONCLUSIONS
When consulting with patients with symptoms of OSA, general practitioners see their primary responsibility as providing a referral for diagnosis by others. General practitioners working with patients in areas of greater need, such as rural/remote areas and those of socio-economic disadvantage, demonstrated interest in being more involved in OSA management. Inequities in access to assessment and management are potential drivers for change in future models of care for OSA in general practice.
背景
阻塞性睡眠呼吸暂停（OSA）的高需求和不断增加已经超出了专业睡眠服务的能力范围，这促使人们考虑是否可以让全科医生在服务提供方面发挥更大的作用。然而，对于澳大利亚全科医生目前在 OSA 护理方面的参与程度、经验和态度知之甚少。本研究的目的是深入分析澳大利亚全科医生对其 OSA 患者护理的经验和看法，为新的全科医疗模式的设计和实施提供信息。
方法
采用目的性抽样方法招募具有年龄、经验和地点最大差异的参与者。进行半结构化访谈，并使用主题分析进行分析。
结果
确定了三个主要主题：（1）全科医生在识别 OSA 症状和促进他人诊断方面非常重要；（2）评估和管理 OSA 的机会不平等；（3）全科医生目前在 OSA 管理方面的作用有限。
结论
当与有 OSA 症状的患者咨询时，全科医生的主要责任是为他人提供诊断转诊。与有更大需求的患者合作的全科医生，如农村/偏远地区和社会经济劣势地区的全科医生，对更多地参与 OSA 管理表现出兴趣。评估和管理机会不平等是未来全科医疗模式中 OSA 护理变化的潜在驱动力。
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