一般医生对儿童诊断测试的看法:一个定性面试研究.
Elizabeth T Thomas1, Margaret Glogowska2, Gail Hayward2
1Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
概括
一般医生对儿童的诊断测试与成人的诊断测试不同,测试门更高. 临床医生的经验和家长的担忧等因素推动了初级保健中的这种差异.
科学领域:
- 儿科初级护理 儿科初级护理
- 诊断测试利用的使用方法
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在英国,大多数儿科医疗保健遇到的情况都发生在全科医院.
- 在初级保健儿童的诊断测试使用方面存在显著差异.
- 不合理的变化可能会影响护理质量,并加剧健康不平等.
研究的目的:
- 调查全科医生 (GPs) 关于在儿科初级保健中使用诊断测试的观点.
- 确定导致儿童测试实践变化的潜在因素.
主要方法:
- 一项定性研究,涉及英格兰18名全科医生和2名实习全科医生的半结构面试.
- 采访是在2023年4月至6月期间进行的.
- 数据使用反射主题分析来分析.
主要成果:
- 一般医生报告说,与成年人相比,儿童的检测门更高,专家转诊门更低.
- 测试的感知实用性各不相同,具体例子如对喘的客观测试.
- 确定的变异驱动因素包括临床医生特定的因素 (风险耐受性,经验) 和外部因素 (父母的担忧,时间限制,指导方针).
结论:
- 结果突出了需要改进的教育,证据和临床指导方针的领域.
- 解决这些问题可以帮助减少诊断测试使用的不合理变化.
- 提高测试利用率可以提高一般实践中儿童医疗保健的质量.
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