Walker Sandra, Daniel Tansy, Yildizcan Mediha, Roddis Jennifer Karen
School of Health and Care Professions, University of Portsmouth, Portsmouth, United Kingdom.
School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom.
Front Health Serv. 2025 Apr 29;5:1473680. doi: 10.3389/frhs.2025.1473680. eCollection 2025.
Self-management is promoted as a mechanism for those with long-term health conditions to manage their condition day-to-day. Changes in access to primary care in the UK have led to an increased patient burden and reduced access to care.
This exploratory study considered the impact of such changes for those managing long term physical and mental health conditions. An interpretative phenomenological analysis approach was adopted. Interviews were conducted with eight individuals affected by long-term physical and/or mental health conditions.
One overarching superordinate theme was identified as significant to all participants: The GP's a stranger. This superordinate theme was fundamental to five lower order themes: Role of GP; Fighting to gain access; Dismissed, depersonalised and devalued; Resourcefulness borne of desperation, and "There was something wrong", which offered insights into the experiences of participants.
Those living with long-term conditions often know when they need to seek additional healthcare support however they shared multiple barriers to accessing this support when needed and reported that the lack of relationship with any health care professional in primary care affected their ability to trust any care advice they were given. Considerations of a new way of operating within a changed paradigm of primary care are explored.
自我管理被推崇为患有长期健康问题的人日常管理自身病情的一种机制。英国初级医疗服务获取方式的变化导致患者负担加重,获得医疗服务的机会减少。
这项探索性研究考量了此类变化对那些管理长期身心健康问题的人的影响。采用了解释现象学分析方法。对八名受长期身心健康问题影响的个体进行了访谈。
确定了一个对所有参与者都具有重要意义的总体上位主题:全科医生是陌生人。这个上位主题是五个下位主题的基础:全科医生的角色;争取获得医疗服务的机会;被忽视、被漠不关心和被贬低;绝望中产生的机智,以及“有些不对劲”,这些下位主题为参与者的经历提供了见解。
患有长期疾病的人通常知道自己何时需要寻求额外的医疗支持,然而,他们在需要时获得这种支持存在多重障碍,并且报告称与初级医疗服务中任何医疗保健专业人员缺乏关系影响了他们对所提供的任何护理建议的信任能力。探讨了在初级医疗服务模式发生变化的情况下一种新的运作方式。