{"title":"饮食失调症患者的管理:基层医疗机构的定性研究。","authors":"Carrie Ashby, Jane Ogden","doi":"10.3399/BJGPO.2024.0014","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>GPs play a key role in the diagnosis and management of eating disorders (EDs).</p><p><strong>Aim: </strong>To explore GPs' experiences of managing patients with EDs.</p><p><strong>Design & setting: </strong>A qualitative study utilising remote semi-structured interviews in the UK.</p><p><strong>Method: </strong>Fourteen GPs were interviewed about their experiences of supporting patients with EDs. The interviews were recorded, transcribed, and analysed using thematic analysis.</p><p><strong>Results: </strong>The analysis described the following four themes: (i) 'Continuity of care', addressing the GP's relationship with patients and family, patient transitions across life stages and geographical areas, and patient non-attendance; (ii) 'The role of guidance', focusing on guidelines and protocols, referrals and specialist professionals as points of contact; (iii) 'Structural barriers', including waiting times, lack of resources, referral criteria, and relationships between services; (iv) 'Confidence and skills', reflecting professional and personal experience in EDs, previous training and training needs. Transcending these themes was the notion of the 'Limits to the care' GPs can provide owing to professional boundaries and the emotional impact of managing patients with EDs.</p><p><strong>Conclusion: </strong>This study found that while GPs want to help patients with EDs many limits remain to the care they can provide owing to both internal and external factors. Funding is required for training and accessible specialist ED support, and greater clarity is needed regarding referral processes if ED management in primary care is to be optimised.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523527/pdf/","citationCount":"0","resultStr":"{\"title\":\"Managing patients with eating disorders: a qualitative study in primary care.\",\"authors\":\"Carrie Ashby, Jane Ogden\",\"doi\":\"10.3399/BJGPO.2024.0014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>GPs play a key role in the diagnosis and management of eating disorders (EDs).</p><p><strong>Aim: </strong>To explore GPs' experiences of managing patients with EDs.</p><p><strong>Design & setting: </strong>A qualitative study utilising remote semi-structured interviews in the UK.</p><p><strong>Method: </strong>Fourteen GPs were interviewed about their experiences of supporting patients with EDs. The interviews were recorded, transcribed, and analysed using thematic analysis.</p><p><strong>Results: </strong>The analysis described the following four themes: (i) 'Continuity of care', addressing the GP's relationship with patients and family, patient transitions across life stages and geographical areas, and patient non-attendance; (ii) 'The role of guidance', focusing on guidelines and protocols, referrals and specialist professionals as points of contact; (iii) 'Structural barriers', including waiting times, lack of resources, referral criteria, and relationships between services; (iv) 'Confidence and skills', reflecting professional and personal experience in EDs, previous training and training needs. Transcending these themes was the notion of the 'Limits to the care' GPs can provide owing to professional boundaries and the emotional impact of managing patients with EDs.</p><p><strong>Conclusion: </strong>This study found that while GPs want to help patients with EDs many limits remain to the care they can provide owing to both internal and external factors. Funding is required for training and accessible specialist ED support, and greater clarity is needed regarding referral processes if ED management in primary care is to be optimised.</p>\",\"PeriodicalId\":36541,\"journal\":{\"name\":\"BJGP Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523527/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJGP Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3399/BJGPO.2024.0014\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"Print\",\"JCR\":\"Q2\",\"JCRName\":\"PRIMARY HEALTH CARE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJGP Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3399/BJGPO.2024.0014","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"Print","JCR":"Q2","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
引用次数: 0
摘要
背景:全科医生(GPs)在饮食失调(EDs)的诊断和管理中发挥着关键作用。目的:探讨全科医生管理饮食失调(EDs)患者的经验:设计与环境:采用远程半结构式访谈进行定性研究:对 14 名全科医生进行了访谈,了解他们为 ED 患者提供支持的经验。对访谈进行记录、转录,并采用主题分析法进行分析:分析描述了四个主题:i) "护理的连续性",涉及全科医生与患者及家属的关系、患者在不同生命阶段和地理区域的转变以及患者不就诊的情况;ii) "指导的作用",侧重于指南和协议、转诊和作为联系点的专业人员;iii) "结构性障碍",包括等待时间、资源缺乏、转诊标准和服务之间的关系;iv) "信心和技能",反映了在急诊室的专业和个人经验、以前的培训和培训需求。超越这些主题的概念是全科医生所能提供的护理的 "局限性",这是由于专业界限和管理急诊室病人对情绪的影响:本研究发现,尽管全科医生希望帮助急症患者,但由于内部和外部因素的影响,他们所能提供的护理服务仍存在许多限制。如果要优化基层医疗机构的急诊室管理,就需要为培训和可获得的急诊室专家支持提供资金,并进一步明确转诊流程。
Managing patients with eating disorders: a qualitative study in primary care.
Background: GPs play a key role in the diagnosis and management of eating disorders (EDs).
Aim: To explore GPs' experiences of managing patients with EDs.
Design & setting: A qualitative study utilising remote semi-structured interviews in the UK.
Method: Fourteen GPs were interviewed about their experiences of supporting patients with EDs. The interviews were recorded, transcribed, and analysed using thematic analysis.
Results: The analysis described the following four themes: (i) 'Continuity of care', addressing the GP's relationship with patients and family, patient transitions across life stages and geographical areas, and patient non-attendance; (ii) 'The role of guidance', focusing on guidelines and protocols, referrals and specialist professionals as points of contact; (iii) 'Structural barriers', including waiting times, lack of resources, referral criteria, and relationships between services; (iv) 'Confidence and skills', reflecting professional and personal experience in EDs, previous training and training needs. Transcending these themes was the notion of the 'Limits to the care' GPs can provide owing to professional boundaries and the emotional impact of managing patients with EDs.
Conclusion: This study found that while GPs want to help patients with EDs many limits remain to the care they can provide owing to both internal and external factors. Funding is required for training and accessible specialist ED support, and greater clarity is needed regarding referral processes if ED management in primary care is to be optimised.