Campion P D, Gabriel J
Soc Sci Med. 1985;20(4):325-30. doi: 10.1016/0277-9536(85)90005-x.
113 families with young children were studied over a 12-month period, when all contacts with the general practitioner and hospital emergency services were recorded. Socioeconomic data was obtained at interview, together with responses to a vignette instrument describing common childhood problems. Health diaries were completed by 70% of mothers, providing further information about illness and mothers anxiety about it. Analyses showed that significant disease in any child was the strongest predictor of frequency of new consultations, with measures of mothers anxiety, number of children in the family, mothers education level and her response to the vignettes also contributing significantly. Socioeconomic deprivation was associated with increased utilisation, even when the effects of prevalence of chronic diseases, size of family and mothers' anxiety were taken into account. From the spontaneous comments made during the vignette responses further information was obtained about how mothers reach the decision to consult the family doctor about children's illness. Thus in a Primary Care setting some systematic differences have been demonstrated between high and low consulting families, which may partly explain the wide variation in spontaneous consultation rates observed.
在12个月的时间里，对113个有幼儿的家庭进行了研究，期间记录了与全科医生和医院急诊服务的所有接触情况。通过访谈获取了社会经济数据，以及对描述常见儿童问题的一个小品文工具的回答。70%的母亲完成了健康日记，提供了关于疾病以及母亲对此焦虑程度的更多信息。分析表明，任何一个孩子患有严重疾病是新咨询频率的最强预测因素，母亲的焦虑程度、家庭中孩子的数量、母亲的教育水平以及她对小品文的回答也都有显著影响。即使考虑到慢性病患病率、家庭规模和母亲焦虑的影响，社会经济剥夺仍与就诊率增加有关。从小品文回答过程中的自发评论中，还获得了关于母亲如何决定就孩子的疾病咨询家庭医生的更多信息。因此，在初级保健环境中，高咨询率家庭和低咨询率家庭之间已显示出一些系统性差异，这可能部分解释了观察到的自发咨询率的广泛差异。
