全科医生对未分化疾病诊治观点的质性研究.docxVIP

全科医生对未分化疾病诊治观点的质性研究

作者：娄铮刘颖任菁菁

来源：《中国现代医生》2022年第32期

????????[摘要]目的通过了解全科医生对未分化疾病（medicallyunspecifieddisease，MUD）的诊治观点，提出临床实践建议，为MUD规范诊治提供理论依据。方法采用目的抽样法，选取浙江省不同地区全科医生17名，组成焦点小组，进行全员团体半结构式深入访谈，采用现象学质性研究方法，对逐字转录所获得的访谈资料进行编码，并运用Colaizzi现象资料七步分析法分析资料，提炼主题。结果通过全科医生对MUD诊治观点的分析，形成3个主题结果：MUD诊断定义不统一，医生思维差异大，反复就医导致过度医疗。结论根据全科医生对MUD诊治观点的分析，提出“掌握疾病规律，统一定义及诊断标准；加强培训，提高对疾病早期识别能力；加强医患沟通，促进医患共同决策”等建议，为MUD诊治规范化提供理论依据。

????????[关键词]未分化疾病；观点；质性研究；焦点小组

????????[中图分类号]R597[文献标识码]A[文章编号]1673-9701（2022）32-0016-04

????????[Abstract]ObjectiveByincludingthegeneralpractitioners'viewsonthediagnosisandtreatmentofmedicallyunspecifieddisease（MUD），thispaperputsforwardclinicalpracticesuggestionstoprovideatheoreticalbasisforthestandardizeddiagnosisandtreatmentofMUD.MethodAtotalof17generalpractitionersfromdifferentregionsofZhejiangProvincewereselectedtoformafocusgrouptoconductsemi–structuredin–depthinterviewswiththeentirestaff.Interviewdataobtainedbyverbatimtranscriptionwerecodedbyphenomenologicalqualitativeresearchmethod，andthesevenstepanalysismethodofColaizziphenomenondatawasusedtoanalyzethedataandrefinethetheme.ResultTheanalysisofgeneralpractitioners’viewsonthediagnosisandtreatmentofMUDformedthreethematicresults：thedefinitionofMUDdiagnosisisunified，doctors'thinkingwasdifferent，andrepeatedmedicaltreatmentleadstoexcessivemedicaltreatment.ConclusionAccordingtotheanalysisofgeneralpractitioners’viewsonthediagnosisandtreatmentofMUD，somesuggestionsareputforward，suchasmasteringthediseaselaw，unifyingthedefinitionanddiagnosticcriteria;strengtheningtrainingtoimprovetheabilityofearlydiseaseidentification;strengtheningdoctor–patientcommunicationandpromotingthejointdecision–makingofdoctorsandpatients，soastoprovideatheoreticalbasisforthestandardizationofdiagnosisandtreatmentofMUD.

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