Cogswell B, Eggert M S
Department of Family Medicine, University of North Carolina at Chapel Hill.
Arch Fam Med. 1993 Jun;2(6):611-9. doi: 10.1001/archfami.2.6.611.
We studied health care consumers' perspectives on provision of preventive care by physicians.
In our qualitative study, we used the grounded theory method and a computerized text-base program (Nota Bene) to analyze 34 focus group interviews with 322 adults from a small Southern town and adjacent rural areas.
Based on our analysis of comments on prevention, we found seven reasons for going to the doctor: response to reminders, periodic examination, response to media messages, attempt to resolve conflicting information, concern about family pathology, attempt to allay anxiety, and illness. In addition, using respondents' comments, we developed a conceptual scheme of four levels of physicians' preventive care: (1) prevention needed, but physician offers no care; (2) physician merely recommends an intervention; (3) physician recommends and suggests ways to implement; and (4) physician recommends, gives implementation suggestions, and offers supportive follow-up. Physicians are more inclined to offer preventive care to patients who manifest pathology than to those who do not.
This conceptual scheme, reflecting patient perspectives, can help primary care physicians fit their styles of practice to different types of patients.
我们研究了医疗保健消费者对医生提供预防性护理的看法。
在我们的定性研究中，我们使用扎根理论方法和一个计算机化的文本库程序（Nota Bene）来分析对来自一个南方小镇及周边农村地区的322名成年人进行的34次焦点小组访谈。
基于我们对预防相关评论的分析，我们发现就医的七个原因：对提醒的回应、定期检查、对媒体信息的回应、试图解决相互矛盾的信息、对家族病史的担忧、试图减轻焦虑以及患病。此外，利用受访者的评论，我们制定了一个医生预防性护理四个层次的概念框架：（1）需要预防，但医生未提供护理；（2）医生仅推荐一种干预措施；（3）医生推荐并建议实施方法；（4）医生推荐、给出实施建议并提供支持性随访。医生更倾向于为有病症表现的患者提供预防性护理，而非没有病症表现的患者。
这个反映患者观点的概念框架有助于初级保健医生使他们的执业方式适应不同类型的患者。
