Huby G, Porter M, Bury J
Department of General Practice, University of Edinburgh, UK.
AIDS Care. 1998 Apr;10 Suppl 1:S83-8. doi: 10.1080/09540129850124398.
This paper is a critique of, and a comment on, the debate about the role of British general practitioners (GPs) in HIV care. We argue that (1) this debate is conducted around arguments which leave significant aspects of GPs' contribution undocumented and unnoticed, and that (2) research has contributed to this omission. The paper reviews the history of the debate about GPs' involvement in HIV care and argues that social research using structured survey methods has reinforced the continuing negative image of GP care. The paper draws on an ethnographic research project in Lothian (Scotland) which found that many people with HIV strongly valued their ongoing personal relationship with their GP. People with HIV also valued the hospital-based outreach system which provided reliable and high quality care, but sometimes experienced the associated interprofessional information sharing and discussion as invasive and controlling. Their GP relationship was valued because it was outside this hospital-based system of care. The paper concludes by suggesting that future developments in GP care should build on this positive aspect of the GP-patient relationship.
本文是对关于英国全科医生（GPs）在艾滋病护理中作用的辩论的批判与评论。我们认为：（1）这场辩论所围绕的论据使全科医生贡献的重要方面未被记录且未被注意到；（2）研究导致了这一疏漏。本文回顾了关于全科医生参与艾滋病护理的辩论历史，并指出使用结构化调查方法的社会研究强化了全科医生护理持续存在的负面形象。本文借鉴了洛锡安（苏格兰）的一项人种志研究项目，该项目发现许多艾滋病患者非常重视他们与全科医生持续的个人关系。艾滋病患者也重视以医院为基础的外展服务系统，该系统提供可靠且高质量的护理，但有时会将相关的跨专业信息共享和讨论视为侵入性和控制性的。他们重视与全科医生的关系，因为这种关系处于这个以医院为基础的护理系统之外。本文最后建议，全科医生护理的未来发展应基于医患关系的这一积极方面。
