全科医生是一个陌生人:一种解释性现象学分析,探索患者在长期条件管理中改变获得初级保健的经验。

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES
Frontiers in health services Pub Date : 2025-04-29 eCollection Date: 2025-01-01 DOI:10.3389/frhs.2025.1473680
Sandra Walker, Tansy Daniel, Mediha Yildizcan, Jennifer Karen Roddis
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引用次数: 0

摘要

自我管理作为一种机制,促进那些有长期健康状况的人管理他们的日常状况。在英国,获得初级保健的机会发生了变化,导致患者负担增加,获得保健的机会减少。方法:本探索性研究考虑了这些变化对那些管理长期身心健康状况的人的影响。采用解释性现象学分析方法。对8名长期受到身体和/或精神健康状况影响的个人进行了访谈。结果:一个重要的上级主题被确定为所有参与者的重要:全科医生是一个陌生人。这个高级主题是5个低级主题的基础:GP的角色;争取进入;被解雇、失去人格、被贬低;“足智多谋”源于绝望,“有些地方出了问题”,这让我们对参与者的经历有了深入的了解。讨论:患有长期疾病的人通常知道他们何时需要寻求额外的医疗保健支持,但他们在需要时获得这种支持时面临多重障碍,并报告说,与初级保健专业人员缺乏关系影响了他们信任给予他们的任何护理建议的能力。考虑到一种新的操作方式在一个变化的范式内的初级保健进行了探索。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The GP's a stranger: an interpretive phenomenological analysis exploring patient experiences of changed access to primary care in the management of long-term conditions.

Introduction: Self-management is promoted as a mechanism for those with long-term health conditions to manage their condition day-to-day. Changes in access to primary care in the UK have led to an increased patient burden and reduced access to care.

Methods: This exploratory study considered the impact of such changes for those managing long term physical and mental health conditions. An interpretative phenomenological analysis approach was adopted. Interviews were conducted with eight individuals affected by long-term physical and/or mental health conditions.

Results: One overarching superordinate theme was identified as significant to all participants: The GP's a stranger. This superordinate theme was fundamental to five lower order themes: Role of GP; Fighting to gain access; Dismissed, depersonalised and devalued; Resourcefulness borne of desperation, and "There was something wrong", which offered insights into the experiences of participants.

Discussion: Those living with long-term conditions often know when they need to seek additional healthcare support however they shared multiple barriers to accessing this support when needed and reported that the lack of relationship with any health care professional in primary care affected their ability to trust any care advice they were given. Considerations of a new way of operating within a changed paradigm of primary care are explored.

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