Kerse N M, Murphy M J, Flicker L, Young D
Department of Public Health and Community Medicine, University of Melbourne, VIC.
Med J Aust. 1997 Oct 20;167(8):423-7. doi: 10.5694/j.1326-5377.1997.tb126654.x.
To explore general practitioners' (GPs') beliefs about health promotion for older people and attitudes towards educational strategies likely to improve practice in this area.
Four discussion groups, each lasting one and a half hours, completed in Melbourne, Australia in August and September 1995. Interviews were transcribed verbatim and analysed for major themes.
A convenience sample of 20 GPs took part; 11 university affiliates, four participant contacts and five GPs from telephone book listings.
GPs' perceptions of their health promotion practice varied from "integrated into all medical care", to "something separate from usual practice". Positive views of older people contrasted with ageist views, with a few GPs expressing a nihilistic approach to medical care of older people. Regardless of the GPs' attitudes, lack of time and reimbursement disincentives were perceived to limit preventive practice and the potential impact of health promotion interventions. GPs felt overwhelmed with their workloads, and initial reactions to the idea of any "new" program were negative. Reactions to educational strategies varied, with choice and relevance to ease of practice being important for GP participation.
GPs differ in their views of health promotion and in their approaches to its delivery for older people. Educational programs are often viewed negatively, but if they offer the opportunity to save time, increased participation may be more likely.
探讨全科医生(GPs)对老年人健康促进的看法以及对可能改善该领域实践的教育策略的态度。
1995年8月和9月在澳大利亚墨尔本完成了四个讨论小组,每个小组持续一个半小时。访谈内容逐字记录,并分析主要主题。
采用便利抽样法,20名全科医生参与;11名大学附属医院医生、4名参与者联系人以及5名从电话簿中列出的全科医生。
全科医生对其健康促进实践的认知各不相同,从“融入所有医疗护理”到“与常规实践分开的事情”。对老年人的积极看法与年龄歧视观点形成对比,少数全科医生对老年人的医疗护理持虚无主义态度。无论全科医生的态度如何,时间不足和报销激励不足被认为限制了预防实践以及健康促进干预措施的潜在影响。全科医生感到工作负担过重,对任何“新”项目的最初反应都是负面的。对教育策略的反应各不相同,对全科医生参与而言,选择和与实践便利性的相关性很重要。
全科医生对健康促进的看法及其为老年人提供健康促进的方式各不相同。教育项目通常被负面看待,但如果它们提供节省时间的机会,可能更有可能提高参与度。