Jung H P, Van Horne F, Wensing M, Hearnshaw H, Grol R
Centre for Quality of Care Research, Nijmegen University and Maastricht University, Nijmegen, The Netherlands.
Soc Sci Med. 1998 Oct;47(8):1077-87. doi: 10.1016/s0277-9536(98)00138-5.
This qualitative study explored those behaviours of a general practitioner which were used by patients in their evaluations of 14 aspects of general practice care. Thirty patients were interviewed immediately after visiting their general practitioner. Interview transcripts were analyzed by two authors, who independently marked general practitioners' behaviours used by patients. Then, these text fragments were categorised into task or affective behaviours according to an existing taxonomy of doctor behaviour in consultations. The results showed that patients reported using task oriented behaviours when they evaluated task oriented aspects of general practice care. However, when they evaluated affective aspects they reported using both affective behaviours and task behaviours, although the latter to a lesser extent. The evaluations of "tell you all you wanted to know about your illness", "explain the purpose and the course of the treatment", "pay attention to your feelings" and "kind and attentive" are clearly linked to specific general practitioners' behaviour. Therefore, evaluations of these aspects can be interpreted straightforwardly. Evaluation of the aspects "GP understands you", "having faith in your GP" and "were you involved in decisions about your medical treatment?" were based on a large variety of physician behaviours which may lead to interpretation problems. Thus, this study gives some important considerations for a better understanding of patients' evaluations of general practice care.
这项定性研究探讨了全科医生的哪些行为被患者用于评估全科医疗服务的14个方面。30名患者在看完全科医生后立即接受了访谈。两位作者对访谈记录进行了分析，他们独立标记了患者提到的全科医生的行为。然后，根据现有的会诊中医生行为分类法，将这些文本片段分为任务行为或情感行为。结果显示，患者在评估全科医疗服务的任务导向方面时提到使用了任务导向行为。然而，在评估情感方面时，他们提到既使用了情感行为也使用了任务行为，尽管后者的程度较小。对“告诉你所有你想知道的关于你疾病的信息”“解释治疗的目的和过程”“关注你的感受”以及“和蔼且专注”这些方面的评估与特定的全科医生行为明显相关。因此，对这些方面的评估可以直接进行解读。对“全科医生理解你”“信任你的全科医生”以及“你参与了关于你医疗治疗的决策吗？”这些方面的评估基于各种各样的医生行为，这可能会导致解读问题。因此，本研究为更好地理解患者对全科医疗服务的评估提供了一些重要的思考。
