全科医学研究中混合方法研究的设计和实施要点及案例解析

Mixed Methods Research in General Practice:Key Points of Design and Implementation and Case Analysis

全科医学研究既关注患者的身体健康,也重视患者的精神感受;既关注医生的职业胜任力,也重视医生的从业动力;既关注医疗服务的质量,也重视医生与患者的关系和合作。这些问题通常需要借助定性研究方法才能获得更有价值的研究结果。但是,一方面,定性研究通常被认为样本量小、主观性强,主要用于问题的探索;另一方面,全科医学领域目前仍以定量研究为主导。因此,整合了定性和定量研究的混合方法研究,结合两者优势,可以更广、更深入地分析特定问题,适用于研究复杂问题,为全科医学研究指出了一条融合临床医学和社会学两大部分的途径。然而,混合方法研究在国内全科医学领域的应用尚处于起步阶段,其设计与实施的规范性亟待提高。因此,本文计划以一项混合方法研究实例介绍开始,对混合方法研究的设计与实施中的关键要点进行详细介绍,以为拟开展混合方法研究的全科医生提供参考。

General practice research focuses on a range of topics,such as patients’ physical health and mental health,physicians’ competencies and career motivation,quality of healthcare and physician-patient relationships and cooperation.However,these are not resolved well only using quantitative research which is still dominated in the field of general practice.In this case,qualitative method is often required,although it is considered to be subjective,and is mainly used to describe a phenomenon that is little known in a small sample.Mixed methods research,which incorporates qualitative and quantitative research and combines the advantages of both,can analyze specific problems more extensively and intensively,is suitable for studying complex problems,and for general practice research as an approach integrating clinical medicine and sociology.However,mixed methods research in general practice is still in its early phase in China,and the standardization of its design and implementation needs to be improved.For better elaborating the key points in the design and implementation of mixed methods research,we detailed a study using mixed methods,providing a reference for general practitioners to carry out mixed methods research.