Virginia Commonwealth University, Richmond, USA.
University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221115946. doi: 10.1177/21501319221115946.
Addressing social needs, health behaviors, and mental health may help patients more than traditional medical care. However, these root causes of poor health are difficult to address and the role of primary care is unclear. This qualitative study assesses patient's willingness and motivations to discuss and accept assistance for these needs from their primary care team.
In July and August of 2020, semi-structured virtual interviews were conducted with family medicine patients (n = 6) and residents of low resource neighborhoods (n = 11) in Richmond, Virginia. Interviews were conducted over Zoom. We conducted a qualitative analysis of patient and resident interview transcripts. A rapid qualitative analysis approach and immersion-crystallization processes were used to identify themes and categories.
Interviewees reported varying degrees of comfort discussing topics with their health care team. They were less comfortable discussing needs they considered outside the realm of "traditional primary care" including finances, transportation, and housing, but interviewees expressed willingness to discuss these needs under certain conditions. Important factors were a strong patient-clinician relationship to create a trusted and safe space for discussion, adequate time for discussion during visits, communication of practices' ability to provide resources to help patients, and ensuring appropriate high quality referrals.
Primary care provides opportunity for identifying and addressing needs that adversely impact health. Some needs are more sensitive for patients to work with their care team on, though, there was willingness to work on need when a strong provider relationship and clinic structure for providing support were in place. This study highlights critical care delivery factors which may be used to enhance patient comfort accepting support for their needs and ultimately improve clinical care and chronic disease management.
解决社会需求、健康行为和心理健康问题可能比传统的医疗护理更能帮助患者。然而，这些健康不良的根本原因难以解决，基层医疗的作用也不明确。本定性研究评估了患者是否愿意并愿意接受其基层医疗团队讨论和接受这些需求援助。
2020 年 7 月至 8 月，在弗吉尼亚州里士满对家庭医学患者（n=6）和资源匮乏社区居民（n=11）进行了半结构化虚拟访谈。访谈通过 Zoom 进行。我们对患者和居民访谈记录进行了定性分析。采用快速定性分析方法和沉浸结晶过程来确定主题和类别。
受访者报告了在与医疗团队讨论某些话题时的舒适度有所不同。他们不太愿意讨论他们认为超出“传统初级保健”范围的需求，包括财务、交通和住房，但受访者表示愿意在某些条件下讨论这些需求。重要因素包括医患关系牢固，为讨论创造一个信任和安全的空间、在就诊期间有足够的讨论时间、沟通诊所提供资源帮助患者的能力，以及确保适当和高质量的转诊。
初级保健为识别和解决对健康有不利影响的需求提供了机会。有些需求患者更愿意与他们的医疗团队一起解决，尽管在建立了牢固的提供者关系和诊所提供支持的结构的情况下，他们愿意解决这些需求。这项研究强调了关键的医疗服务提供因素，这些因素可以用来提高患者接受支持其需求的舒适度，最终改善临床护理和慢性病管理。
