Hopton J, Hogg R, McKee I
Department of General Practice, University of Edinburgh.
BMJ. 1996 Oct 19;313(7063):991-4. doi: 10.1136/bmj.313.7063.991.
To investigate patients' accounts of calling the doctor out of hours.
Qualitative analysis of semi-structured interviews with two groups of patients who called their doctors out of hours from one general practice.
23 people who had called the doctor on their behalf or on behalf of another adult and 23 people who had called on behalf of a child between 6 pm and 8 am on a week day (omitting the weekend from 6 pm on Friday to 8 am on Monday).
although respondents described symptoms as the main reason for the call, they also described a range of other factors that led to the call, including their feelings, concerns about specific illnesses, their responsibility for others, and their previous attempts to manage the problem themselves. They also described past experiences with health services that were important in explaining the current out of hours call or explaining their general approach to using services.
The pursuit of a model of out of hours care based on medical necessity that neglects the psychosocial context of illness may not be appropriate. The importance of previous experiences of health services and contacts with health professionals in explaining current service use requires wider acknowledgement by health professionals across sectors. Separate educational programmes to encourage patients to use out of hours services more appropriately that neglect these issues may be too simplistic.
调查患者非工作时间呼叫医生的情况。
对来自一家全科诊所的两组在非工作时间呼叫医生的患者进行半结构化访谈的定性分析。
23名代表自己或其他成年人呼叫医生的人，以及23名在工作日下午6点至上午8点（不包括从周五下午6点到周一上午8点的周末时间）代表儿童呼叫医生的人。
尽管受访者将症状描述为呼叫医生的主要原因，但他们也描述了一系列导致呼叫的其他因素，包括他们的感受、对特定疾病的担忧、对他人的责任以及他们之前自行处理问题的尝试。他们还描述了过去与医疗服务机构的经历，这些经历对于解释当前的非工作时间呼叫或他们使用服务的一般方式很重要。
追求基于医疗必要性而忽视疾病社会心理背景的非工作时间护理模式可能并不合适。医疗服务机构过去的经历以及与医疗专业人员的接触在解释当前服务使用情况方面的重要性，需要各部门的医疗专业人员更广泛地认识到。单独开展鼓励患者更恰当地使用非工作时间服务却忽视这些问题的教育项目可能过于简单化。
