Endacott R
Department of Child Health, University of Exeter, England.
J Adv Nurs. 1997 Mar;25(3):471-6. doi: 10.1046/j.1365-2648.1997.1997025471.x.
Meeting needs is the aim of health care frequently espoused in textbooks, policy documents and reports of research studies; provision of health care is also now described as 'needs-based', rather than 'service-based'. The purpose of this paper is to explore the concept of need, using concept analysis, with the aim of providing greater clarity. Two approaches to concept analysis are compared: the linear model proposed by Walker and Avant and Rodgers' cyclical model. On both a philosophical and practical level, Rodgers' model was felt to be more appropriate for analysis of the concept of need. The rigid divisions which the Walker and Avant model seeks to establish (particularly in relation to the construction of additional cases) were felt to restrict, rather than clarify the concept. The attributes, antecedents, consequences and references of need are described, following stratified random sampling of the available literature, and a model case is presented. The themes of priority and perception of need arose consistently within the literature, highlighting the value-laden nature of the concept and the importance of achieving a common understanding to enable purchasers, providers and consumers to better satisfy health care needs.
满足需求是教科书、政策文件和研究报告中经常倡导的医疗保健目标；现在，医疗保健的提供也被描述为“基于需求”，而非“基于服务”。本文旨在通过概念分析来探讨需求的概念，以使其更加清晰。文章比较了两种概念分析方法：沃克和阿万特提出的线性模型以及罗杰斯的循环模型。在哲学和实践层面上，人们认为罗杰斯的模型更适合用于需求概念的分析。沃克和阿万特模型试图建立的严格划分（特别是在构建额外案例方面）被认为会限制而非阐明该概念。在对现有文献进行分层随机抽样后，描述了需求的属性、前提、后果和参考文献，并给出了一个典型案例。文献中始终出现了需求的优先级和认知等主题，凸显了该概念的价值负载性质以及达成共识对于使购买者、提供者和消费者更好地满足医疗保健需求的重要性。
