Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Department of Research, SingHealth Polyclinics, Singapore, Singapore.
PLoS Negl Trop Dis. 2023 Apr 27;17(4):e0011302. doi: 10.1371/journal.pntd.0011302. eCollection 2023 Apr.
Outpatient management for dengue fever is the mainstay of treatment for most dengue cases. However, severe dengue can develop rapidly while patients are at home. Understanding the self-care practices and healthcare-seeking behaviours among dengue patients managed as outpatients will help improve the delivery of care to these patients.
This study aimed to explore the self-care practices, health-seeking behaviour and outpatient management of dengue fever from the perspectives of patients and primary care physicians.
This qualitative study used in-depth interviews and focus group discussions to obtain information from laboratory-confirmed dengue patients who received outpatient care and primary care physicians who cared for them. Patients and physicians shared their experiences and perceptions of self-care practices, decisions to seek urgent care, and outpatient management procedures and visit frequency. Data were coded and analysed using thematic analysis.
13 patients and 11 physicians participated. We discovered that the use of traditional remedies was common with patients perceiving no harm from it, whereas physicians did not see a benefit. Dengue patients' knowledge of warning signs was inadequate despite the information being provided by physicians during clinical follow-up visits. Regarding the decision to seek urgent medical care, physicians assumed patients would seek help immediately once they experienced warning signs. However, for the patients, other factors influenced their health-seeking behaviour, such as their personal perceptions of symptom severity and often more importantly, their social circumstances (e.g., availability of childcare). Patients also described regular outpatient follow-up for dengue as inconvenient. There was variation in the prescribed outpatient follow-up interval recommended by participating physicians who complained about the lack of clear guidelines.
Perceptions around self-care practices, health-seeking behaviour and outpatient management of dengue often differed between physicians and patients, especially on comprehension of dengue warning signs. Addressing these gaps between patient and physician perceptions and recognition of patient drivers of health-seeking behaviour are needed to improve the safety and delivery of outpatient care for dengue patients.
登革热的门诊管理是大多数登革热病例治疗的主要方法。然而，严重的登革热可能在患者居家时迅速发展。了解门诊管理的登革热患者的自我护理实践和就医行为有助于改善对这些患者的护理提供。
本研究旨在从患者和初级保健医生的角度探讨登革热的自我护理实践、就医行为和门诊管理。
这项定性研究使用深入访谈和焦点小组讨论从接受门诊护理的实验室确诊登革热患者和照顾他们的初级保健医生那里获取信息。患者和医生分享了他们在自我护理实践、决定寻求紧急护理以及门诊管理程序和就诊频率方面的经验和看法。使用主题分析对数据进行编码和分析。
共有 13 名患者和 11 名医生参与。我们发现，患者普遍使用传统疗法，尽管医生认为这些疗法没有好处，但他们认为这些疗法没有危害。尽管医生在临床随访期间向患者提供了信息，但登革热患者对警告信号的了解不足。关于寻求紧急医疗救助的决定，医生认为一旦患者出现警告信号，他们会立即寻求帮助。然而，对于患者来说，其他因素也会影响他们的就医行为，例如他们对症状严重程度的个人看法，通常更重要的是他们的社会环境（例如，是否有儿童保育）。患者还描述了定期门诊随访对登革热很不方便。参与的医生建议的门诊随访间隔时间不同，他们抱怨缺乏明确的指南。
医生和患者对自我护理实践、就医行为和登革热门诊管理的看法经常存在差异，尤其是在对登革热警告信号的理解上。需要解决患者和医生之间的这些认知差距，并认识到患者就医行为的驱动因素，以提高登革热患者门诊护理的安全性和效果。
