干旱区生态环境知识资源中心(Arid): 'There is no such thing as getting sick justly or unjustly' - a qualitative study of clinicians' beliefs on the relevance of personal responsibility as a basis for health prioritisation

Arid

DOI	10.1186/s12913-020-05364-6
	'There is no such thing as getting sick justly or unjustly' - a qualitative study of clinicians' beliefs on the relevance of personal responsibility as a basis for health prioritisation
	Traina, Gloria; Feiring, Eli
通讯作者	Traina, Gloria
来源期刊	BMC HEALTH SERVICES RESEARCH
EISSN	1472-6963
出版年	2020
卷号	20 期号:1
英文摘要	BackgroundConcerns have been raised regarding the reasonableness of using personal health responsibility as a principle or criterion for setting priorities in healthcare. While this debate continues, little is known about clinicians' views on the role of patient responsibility in clinical contexts. This paper contributes to the knowledge on the empirical relevance of personal responsibility for priority setting at the clinical level.MethodsA qualitative study of Norwegian clinicians (n=15) was designed, using semi-structured interviews with vignettes to elicit beliefs on the relevance of personal responsibility as a basis for health prioritisation. Sampling was undertaken purposefully. The interviews were conducted in three hospital trusts in South-Eastern Norway between May 2018 and February 2019 and were analysed with conceptually driven thematic analysis.ResultsThe findings suggest that clinicians endorsed a general principle of personal health responsibility but were reluctant to introduce personal health responsibility as a formal priority setting criterion. Five main objections were cited, relating to avoidability, causality, harshness, intrusiveness, and inequity. Still, both retrospective and prospective attributions of personal responsibility were perceived as relevant in specific clinical settings. The most prominent argument in favour of personal health responsibility was grounded in the idea that holding patients responsible for their conduct would contribute to the efficient use of healthcare resources. Other arguments included fairness to others, desert and autonomy, but such standpoints were controversial and held only marginal relevance.ConclusionsOur study provides important novel insights into the clinicians' beliefs about personal health responsibility improving the empirical knowledge concerning its fairness and potential applications to healthcare prioritisation. These findings suggest that although personal health responsibility would be difficult to implement as a steering criterion within the main priority setting framework, there might be clinical contexts where it could figure in prioritisation practices. Additional research on personal health responsibility would benefit from considering the multiple clinical encounters that shape doctor-patient relationships and that create the information basis for eligibility and prioritisation for treatment.
英文关键词	Norway Personal health responsibility Clinical priority setting Clinicians' beliefs Vignettes Conceptually driven thematic analysis
类型	Article
语种	英语
国家	Norway
开放获取类型	Green Published, gold
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000540258000008
WOS关键词	HEPATITIS-C TREATMENT ; INJECTING DRUG-USERS ; PRIORITY ; ATTITUDES ; PREJUDICE ; REFORM ; PERCEPTIONS ; RESOURCES ; PRESTIGE ; SURGERY
WOS类目	Health Care Sciences & Services
WOS研究方向	Health Care Sciences & Services
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/318772
作者单位	Univ Oslo, Dept Hlth Management & Hlth Econ, Post Box 1089 Blindern, N-0317 Oslo, Norway
推荐引用方式 GB/T 7714	Traina, Gloria,Feiring, Eli. 'There is no such thing as getting sick justly or unjustly' - a qualitative study of clinicians' beliefs on the relevance of personal responsibility as a basis for health prioritisation[J],2020,20(1).
APA	Traina, Gloria,&Feiring, Eli.(2020).'There is no such thing as getting sick justly or unjustly' - a qualitative study of clinicians' beliefs on the relevance of personal responsibility as a basis for health prioritisation.BMC HEALTH SERVICES RESEARCH,20(1).
MLA	Traina, Gloria,et al."'There is no such thing as getting sick justly or unjustly' - a qualitative study of clinicians' beliefs on the relevance of personal responsibility as a basis for health prioritisation".BMC HEALTH SERVICES RESEARCH 20.1(2020).