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患者讲述痛苦和不良生活经历的医学相关性认知:挪威全科医生的焦点小组研究。

Perceptions of the medical relevance of patients` stories of painful and adverse life experiences: a focus group study among Norwegian General Practitioners.

机构信息

Tingvoll Healthcare Centre, Tingvoll, Norway.

General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

出版信息

Int J Qual Stud Health Well-being. 2022 Dec;17(1):2108560. doi: 10.1080/17482631.2022.2108560.

Abstract

PURPOSE

Adverse life experiences increase the risk of health problems. Little is known about General Practitioners' (GPs') thoughts, clinical concepts, and work patterns related to eliciting, including, or excluding their patients' stories of painful and adverse life experiences. We wanted to explore GPs' perceptions of the medical relevance of stories of painful and adverse life experiences, and to focus on what hinders or facilitates working with such stories.

METHOD

Eighteen Norwegian GPs participated in three focus group interviews. The interviews were analysed using reflexive thematic analysis.

RESULTS

The participating GPs' views on the clinical relevance of patients' painful and adverse experiences varied considerably. Our analysis revealed two distinct stances: a , and an . GPs encountered barriers to exploring such stories: scepticism on behalf of the medical discipline; scepticism on behalf of the patients; and, uncertainty regarding how to address stories of painful and adverse experiences in consultations. Work with painful stories was best facilitated when GPs manifested personal openness and prepared availability, within the context of a doctor-patient relationship based on trust.

CONCLUSIONS

Clearer processes for handling biographical information and life experiences that affect patients' health are needed to facilitate the work of primary care physicians.

摘要

目的

不良生活经历会增加健康问题的风险。全科医生(GP)在引出、包括或排除患者痛苦和不良生活经历方面的想法、临床概念和工作模式方面的了解甚少。我们希望探讨全科医生对患者痛苦和不良生活经历的医学相关性的看法,并关注阻碍或促进处理此类故事的因素。

方法

18 名挪威全科医生参加了三次焦点小组访谈。使用反思性主题分析对访谈进行了分析。

结果

参与研究的全科医生对患者痛苦和不良经历的临床相关性的看法差异很大。我们的分析揭示了两种截然不同的立场:一种是 ,另一种是 。全科医生在探索此类故事时遇到了障碍:医学学科的怀疑态度;患者的怀疑态度;以及在咨询中如何处理痛苦和不良经历的故事方面的不确定性。当全科医生在基于信任的医患关系中表现出个人的开放和准备提供帮助时,处理影响患者健康的传记信息和生活经历的工作就会得到更好的促进。

结论

需要更清晰的流程来处理影响患者健康的传记信息和生活经历,以促进初级保健医生的工作。

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