Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.
Deakin University, Melbourne, Australia.
BMC Health Serv Res. 2024 Sep 27;24(1):1117. doi: 10.1186/s12913-024-11506-x.
The experiences of GPs in Australia highlight key considerations regarding workload demands, remuneration incentives and the practical implications of working in regions with high ethnic density. This exploration helps to understand the elements that influence GPs delivery of care, particular for refugee women who exhibit disproportionately higher rates of chronic pain. This qualitative study explored the experiences of GPs providing care for refugee women living with chronic pain.
Semi-structured interviews were undertaken with 10 GPs (9 female and 1 male) practicing across metropolitan Melbourne, Australia. GPs were recruited via purposive sampling and a snowballing strategy. Participants work experience ranged from one to 32 years. Audio recordings of the interviews were transcribed verbatim and stored in qualitative data Nvivo 12 software for coding. Transcripts of interviews were analysed thematically using a phenomenological approach.
Three overarching themes were identified: (1) meeting the needs of refugee women living with chronic pain; (2) the role of the GP; and (3) the challenges of the health care system. These themes reflected the complexity of consultations which arose, in part, from factors such as trust, the competencies of clinician's and the limitations posed by time, funding and interpreter use.
GPs acknowledged the uniqueness of refugee women's chronic pain needs and whilst doctors welcomed care, many were often challenged by the complex nature of consultations. Those that worked in settings that aligned with refugee women's needs highlighted the importance of cultivating culturally safe clinical environments and listening to their patients' stories. However, system level challenges such as time, funding and resource constraints created significant challenges for GPs. Exploring GPs experiences allows for a better understanding of how vectors of disadvantage intersect in health care and highlights the need to better support doctors to improve health care provision for refugee women living with chronic pain.
澳大利亚全科医生的经验突显了与工作量需求、薪酬激励以及在族裔密度高的地区工作的实际影响相关的关键考虑因素。这种探索有助于了解影响全科医生提供护理的因素，特别是对于慢性疼痛发病率不成比例高的难民妇女。本定性研究探讨了为患有慢性疼痛的难民妇女提供护理的全科医生的经验。
在澳大利亚墨尔本大都市地区，对 10 名全科医生（9 名女性和 1 名男性）进行了半结构化访谈。全科医生通过目的性抽样和滚雪球策略招募。参与者的工作经验从 1 年到 32 年不等。采访的音频记录被逐字转录并存储在定性数据 Nvivo 12 软件中进行编码。使用现象学方法对访谈记录进行主题分析。
确定了三个总体主题：（1）满足患有慢性疼痛的难民妇女的需求；（2）全科医生的角色；（3）医疗保健系统的挑战。这些主题反映了咨询的复杂性，部分原因是信任、临床医生的能力以及时间、资金和口译员使用的限制等因素。
全科医生承认难民妇女慢性疼痛需求的独特性，尽管医生欢迎护理，但许多人经常受到咨询复杂性的挑战。那些在与难民妇女需求一致的环境中工作的人强调了培养文化安全临床环境和倾听患者故事的重要性。然而，时间、资金和资源限制等系统层面的挑战给全科医生带来了巨大挑战。探讨全科医生的经验可以更好地了解劣势向量如何在医疗保健中相互交叉，并强调需要更好地支持医生，以改善患有慢性疼痛的难民妇女的医疗保健服务。
