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首页> 外文期刊>BMC International Health and Human Rights >Coping with uncertainty during healthcare-seeking in Lao PDR
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Coping with uncertainty during healthcare-seeking in Lao PDR

机译：老挝人民民主共和国寻求医疗服务过程中的不确定性

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Background Uncertainty is regarded as a central dimension in the experience of illness and in the processes of alleviating it. Few studies from resource-poor settings have investigated this and how it interacts with other factors. This study aims to shed light on how healthcare-seeking develops in the context of multiple medical alternatives and to understand what bearing uncertainty has on this process. Methods The study was conducted in six purposively selected rural communities in Lao PDR. In each community, two focus group discussions were held: first with mothers and then with fathers of children younger than five years old. Eleven in-depth interviews with caregivers of severely sick children were conducted. Subsequently, traditional healers, drug vendors, community health workers, nurses and medical doctors were recruited for interviews or group discussions. The data were transcribed and key themes and similarities were identified. Additional readings were conducted to better understand the interactions of factors during which uncertainty was identified as one of several factors mentioned during interviews and focus group discussions. Results Care-seekers expressed a strong preference for initially seeking local providers. Subsequently, multiple providers were consulted to increase the chances of recovery. This resulted in patients leaving the health facilities before recovery and in ending the recommended treatment regime prematurely. These healthcare-seeking decisions reflect the social significance of being a responsible caregiver and of showing respect for household norms. In general, healthcare-seeking was shrouded in uncertainty when it came to selecting the right provider, the likelihood of finding the real cause of the illness, spending savings on treatments and ultimately the likelihood of recovery. Conclusions Care-seekers’ initial strong preference for local providers irrespective of the providers’ legitimacy indicates the need for a robust primary healthcare system. Care-seekers’ subsequent consultations must be understood in the light of their uncertainty regarding the skills of the available providers. The social connotations of seeking healthcare including the vulnerability of poor households in public health facilities were taken into account to only a limited extent by health workers. Health workers should have greater awareness of the social and cultural aspects of seeking care.
机译：背景技术不确定性被认为是疾病经历和缓解过程中的中心问题。在资源匮乏的环境中，很少有研究对此进行过研究，以及它如何与其他因素相互作用。这项研究旨在阐明在多种医疗选择的背景下寻求医疗保健的方式，以及了解在此过程中存在哪些不确定性。方法本研究在老挝人民民主共和国有目的的六个农村社区中进行。在每个社区中，进行了两次焦点小组讨论：首先与母亲，然后与五岁以下儿童的父亲进行讨论。对重病儿童的看护人进行了11次深入访谈。随后，招募了传统的治疗师，药物供应商，社区卫生工作者，护士和医生进行访谈或小组讨论。转录数据并确定关键主题和相似之处。进行了额外的阅读，以更好地理解不确定性被认为是访谈和焦点小组讨论中提到的几个因素之一的因素之间的相互作用。结果求职者对初次寻求当地提供者表示强烈的偏好。随后，咨询了多个提供商以增加恢复的机会。这导致患者在康复之前离开卫生机构，并过早终止了推荐的治疗方案。这些寻求医疗保健的决定反映了成为负责任的护理员和尊重家庭规范的社会意义。一般而言，在选择合适的提供者，寻找疾病真正原因的可能性，节省治疗费用以及最终康复的可能性方面，寻求医疗服务的不确定性都笼罩着。结论寻求医疗服务者最初对本地医疗服务提供者的强烈偏好，无论医疗服务提供者的合法性如何，都表明需要强大的基础医疗保健系统。必须根据求职者对可用提供者技能的不确定性来理解其后续咨询。卫生工作者仅在有限的范围内考虑了寻求医疗保健的社会含义，包括贫困家庭在公共卫生设施中的脆弱性。卫生工作者应更加了解寻求护理的社会和文化方面。

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