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德国就业全科医生的核心价值观——一项定性研究。

Core values of employed general practitioners in Germany - a qualitative study.

机构信息

Department of general practice and health services research, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.

出版信息

BMC Prim Care. 2024 Jan 6;25(1):14. doi: 10.1186/s12875-023-02255-7.

Abstract

BACKGROUND

"Core values" help to guide practice of health care delivery. The core values of general practice are described in the European definition of general practice by WONCA, e.g. a holistic, comprehensive and continuous care. They may be associated with the idea that the general practitioner is the owner of the practice rather than an employee.

OBJECTIVES

The objective was to examine the core values of employed GPs in their professional setting and their practical manifestation.

METHODS

From April to May 2021, we conducted 17 semi-structured telephone-interviews with employed GPs in two districts in Baden-Wuerttemberg, Germany. The data were analysed using qualitative content analysis.

RESULTS

We identified twelve core values, including values relevant to patient care and values relevant to the lives of employed GPs. Values with high relevance were job satisfaction, the professional distance from patients, collaboration and collegial exchange, comprehensive care, adequate consultation time and availability to patients. Values with heterogeneous relevance were continuity of care, waiting times and medical autonomy. The value "availability" of employed GPs to patients was associated with both patient care and personal life. The limited availability of employed GPs was accompanied by tensions between these two trends and other values.

CONCLUSION

The values of employed GPs are partly consistent with the current WONCA definition of general practice. There were also indications of new values. The increase in the proportion of employed GPs implies a need to reflect on the core values of general practice, taking into account factors on the part of employed GPs, patients, and practice organisation.

摘要

背景

“核心价值观”有助于指导医疗保健实践。世界家庭医生组织(WONCA)对全科医学的欧洲定义中描述了全科医学的核心价值观,例如整体、全面和连续的医疗。这些价值观可能与全科医生是诊所的所有者而不是员工的想法有关。

目的

本研究旨在考察在职全科医生在其专业环境中的核心价值观及其实际表现。

方法

2021 年 4 月至 5 月,我们在德国巴登-符腾堡州的两个地区对 17 名在职全科医生进行了 17 次半结构式电话访谈。使用定性内容分析法对数据进行分析。

结果

我们确定了 12 项核心价值观,包括与患者护理相关的价值观和与在职全科医生生活相关的价值观。具有高度相关性的价值观包括工作满意度、与患者的专业距离、合作和同事交流、全面的医疗、充足的咨询时间和对患者的可及性。具有异质相关性的价值观包括连续性护理、等待时间和医疗自主权。在职全科医生对患者的“可及性”既与患者护理有关,也与个人生活有关。在职全科医生的可及性有限,这伴随着这两种趋势与其他价值观之间的紧张关系。

结论

在职全科医生的价值观在一定程度上与当前 WONCA 对全科医学的定义一致。也有新价值观的迹象。在职全科医生比例的增加意味着需要考虑到在职全科医生、患者和实践组织的因素,对全科医学的核心价值观进行反思。

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