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澳大利亚农村和偏远地区全科医生参与高 acuity 患者的定性研究

A Qualitative Study of Rural and Remote Australian General Practitioners' Involvement in High-Acuity Patients.

机构信息

Riverland Mallee Coorong Local Health Network, Berri, SA 5343, Australia.

School of Allied Health, Exercise and Sports Sciences, Faculty of Science and Health, Charles Sturt University, Albury, NSW 2640, Australia.

出版信息

Int J Environ Res Public Health. 2023 Mar 3;20(5):4548. doi: 10.3390/ijerph20054548.

Abstract

This study aimed to understand the experiences, barriers, and facilitators of rural general practitioners' involvement with high-acuity patients. Semi-structured interviews with rural general practitioners in South Australia who had experience delivering high-acuity care were audio-recorded, transcribed verbatim, and analyzed through content and thematic approaches incorporating Potter and Brough's capacity-building framework. Eighteen interviews were conducted. Barriers identified include the inability to avoid high-acuity work in rural and remote areas, pressure to handle complex presentations, lack of appropriate resources, lack of mental health support for clinicians, and impacts on social life. Enablers included a commitment to community, comradery in rural medicine, training, and experience. We concluded that general practitioners are a vital pillar of rural health service delivery and are inevitably involved in disaster and emergency response. While the involvement of rural general practitioners with high-acuity patients is complex, this study suggested that with the appropriate system, structure and role supports, rural general practitioners could be better empowered to manage high-acuity caseloads locally.

摘要

本研究旨在了解农村全科医生参与高急症患者工作的经验、障碍和促进因素。对南澳大利亚有高急症护理经验的农村全科医生进行了半结构化访谈,对访谈进行了录音、逐字转录,并通过包含 Potter 和 Brough 的能力建设框架的内容和主题方法进行了分析。共进行了 18 次访谈。确定的障碍包括在农村和偏远地区无法避免高急症工作、处理复杂表现的压力、缺乏适当的资源、缺乏对临床医生的心理健康支持,以及对社会生活的影响。促进因素包括对社区的承诺、农村医学中的同志情谊、培训和经验。我们的结论是,全科医生是农村卫生服务提供的重要支柱,不可避免地参与灾害和应急响应。虽然农村全科医生参与高急症患者的工作很复杂,但这项研究表明,通过适当的系统、结构和角色支持,可以更好地授权农村全科医生在当地管理高急症病例。

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