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德国全科医生的疾病行为和影响因素及其对医疗保健系统的利用:一项定性研究。

Illness behaviour and influencing aspects of general practitioners in Germany and their use of the health care system: a qualitative study.

机构信息

Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany

Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany.

出版信息

BMJ Open. 2022 Sep 30;12(9):e051404. doi: 10.1136/bmjopen-2021-051404.

Abstract

OBJECTIVES

The aim of this study was to explore aspects that play a role when general practitioners (GPs) become ill and thus gain a more comprehensive understanding of the overall illness behaviour of GPs and their use of the healthcare system.

SETTING

Primary care practices in Thuringia, Germany.

PARTICIPANTS

Convenience sample of 16 GPs.

DESIGN

Qualitative study design with semistructured interviews and content analysis.

RESULTS

Using our approach of having participants report their own episodes of illness, we found that self-treatment was practised and accepted by all 16 participants. The widespread use of naturopathy and complementary methods seems to be a special feature of German GPs. Formal use of the healthcare system mainly took place through direct consultation with specialists.Our study revealed various aspects influencing the illness behaviour of the GPs and their use of the healthcare system. Some aspects also apply to lay patients, but it became clear how strongly illness behaviour is influenced by participants' activities as physicians. Noteworthy and less described aspects are especially the influence of patients and practice staff, the influence of biographical and professional imprint and the attitudes and values of the physicians.Complex inter-relationships were found between illness behaviour and influencing aspects; these are subjected to a dynamic and recursive process.

CONCLUSIONS

The illness behaviour of German GPs seems to be comprehensively influenced by their activities as responsible healthcare providers. The ability to perceive and reflect in this regards should already be actively promoted in studies and further education. Further research is needed for a better understanding of the inter-relationships.

摘要

目的

本研究旨在探讨全科医生患病时所涉及的各个方面,从而更全面地了解全科医生的整体疾病行为及其对医疗保健系统的利用。

设置

德国图林根州的初级保健诊所。

参与者

16 名全科医生的便利样本。

设计

定性研究设计,采用半结构化访谈和内容分析。

结果

通过让参与者报告自己的患病经历,我们发现所有 16 名参与者都采用了自我治疗且这种做法被接受。顺势疗法和补充疗法的广泛应用似乎是德国全科医生的一个特点。正式利用医疗保健系统主要通过与专家的直接咨询进行。我们的研究揭示了影响全科医生疾病行为及其利用医疗保健系统的各种因素。其中一些因素也适用于普通患者,但很明显,疾病行为受到参与者作为医生的活动的强烈影响。值得注意且描述较少的方面是患者和实践工作人员的影响、传记和职业印记的影响以及医生的态度和价值观。在疾病行为和影响因素之间发现了复杂的相互关系;这些关系受到动态和递归过程的影响。

结论

德国全科医生的疾病行为似乎受到其作为负责任的医疗保健提供者的活动的全面影响。在研究和继续教育中,应该积极促进这种感知和反思的能力。需要进一步研究以更好地理解这些相互关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47b3/9528620/c6def53fbc7a/bmjopen-2021-051404f01.jpg

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