Coulter A, Peto V, Doll H
Department of Public Health and Primary Care, University of Oxford, Radcliffe Infirmary, UK.
Fam Pract. 1994 Mar;11(1):67-74. doi: 10.1093/fampra/11.1.67.
The aim of this study was to investigate the treatment preferences of patients consulting their general practitioners (GPs) for heavy menstrual bleeding and the influence of these preferences and other factors on GPs' management decisions. One-hundred and twenty-nine GPs recruited 483 eligible patients into the study, of whom 425 (88.0%) returned completed questionnaires. 35.6% of patients indicated that they had a strong treatment preference. Logistic regression analysis revealed that the strongest independent predictors of the likelihood of having a treatment preference were higher education and previous consultations for gynaecological problems. Among those who expressed a preference for either drug therapy or surgery, those with severe symptoms and those who had not received higher education were more likely to prefer surgical treatment. The likelihood of referral was related to a preference for surgery, as expressed by the patient and as perceived by the GP. Patients were much more likely to be referred to a gynaecologist if they had a history of prior surgery (odds ratio 3.21) and if their GP was male (odds ratio 1.76).
本研究旨在调查因月经过多而咨询全科医生（GP）的患者的治疗偏好，以及这些偏好和其他因素对全科医生管理决策的影响。129名全科医生招募了483名符合条件的患者参与研究，其中425名（88.0%）返回了完整的问卷。35.6%的患者表示他们有强烈的治疗偏好。逻辑回归分析显示，具有治疗偏好可能性的最强独立预测因素是高等教育程度和既往妇科问题咨询史。在那些对药物治疗或手术有偏好的患者中，症状严重的患者和未接受过高等教育的患者更倾向于手术治疗。转诊的可能性与患者表达的和全科医生感知到的对手术的偏好有关。如果患者有既往手术史（比值比3.21）以及其全科医生为男性（比值比1.76），那么他们被转诊至妇科医生处的可能性要大得多。
