Department of General Practice, Monash University, Victoria, Australia.
Monash Centre for Health Research and Implementation (MCHRI), Victoria, Australia.
Chronic Illn. 2023 Sep;19(3):557-570. doi: 10.1177/17423953221101337. Epub 2022 May 15.
To compare self-reported levels of 'anticipated' stigma and experience of care in general practice between current and ex-smokers living with COPD, other chronic illnesses, or those with no chronic conditions.
Participants completed an online survey, advertised through social media, about their experience of care from general practitioners (GPs) in the past 12 months. Respondents self-reported doctor-diagnosed chronic illnesses. Experience of care and anticipated stigma was assessed using validated questions. Multi-nominal regressions were used to determine independent effect of smoking status on anticipated stigma and other indicators of patient experience in primary care.
Patients with COPD (n = 161) reported significantly higher anticipated stigma scores compared to those with other chronic conditions (n = 225) and this was strongly related to delayed or avoidance in seeking help from a GP when needed. This relationship remained irrespective of current smoking status. There was no difference between groups for relational components of experience of care.
Primary care patients living with COPD reported worse experience of care across several domains and were more likely to anticipate experiencing stigma in the GP setting irrespective of their current smoking status compared to those with other chronic illnesses or no chronic illnesses.
比较当前吸烟者、戒烟者、慢阻肺患者、其他慢性病患者和无慢性病患者在全科医疗中自我报告的“预期”耻辱感水平和一般医疗体验。
参与者通过社交媒体在线完成了一项关于过去 12 个月内全科医生（GP）护理体验的调查。受访者自我报告了医生诊断的慢性疾病。使用经过验证的问题评估护理体验和预期耻辱感。采用多项回归分析确定吸烟状况对预期耻辱感和初级保健中其他患者体验指标的独立影响。
与患有其他慢性疾病（n=225）的患者相比，慢阻肺患者（n=161）报告的预期耻辱感评分明显更高，这与需要时向 GP 寻求帮助时的延迟或回避密切相关。无论当前的吸烟状况如何，这种关系仍然存在。体验关怀的关系组成部分在各组之间没有差异。
与其他患有慢性疾病或无慢性疾病的患者相比，患有慢阻肺的初级保健患者在多个领域的医疗体验较差，并且更有可能在全科医生就诊时预期会经历耻辱感，而不论其当前的吸烟状况如何。
