Læknablaðið - 15.08.1990, Blaðsíða 32

298
LÆKNABLAÐIÐ
Answers by GPs
Questions
þessari könnun var hvergi fjallað beinlínis
um háls-, nef- og eymalækningar og því þótti
forvitnilegt að taka þá sérgrein með. Það er
athyglisvert að yngri læknar eru mun fúsari
til þátttöku en þeir eldri og kann það að skýra
góðar heimtur hjá háls-, nef- og eymalæknum,
þar sem meðalaldur þeirra er lægri en í hinum
sérgreinunum.
Nokkrir þátttakenda nefndu, að erfitt væri að
svara spumingunum og sumar þeirra mætti
skilja á marga vegu. Sama sinnis voru margir
sem ekki sendu inn svör sín, en þetta er út af
fyrir sig þekkt vandamál í rannsóknum þar
sem notað er spumingaeyðublað. Ætla má að
þessir erfiðleikar hafi þó komið jafnt niður á
öllum. Ef heimilislæknahópurinn er athugaður
sérstaklega kemur í ljós að þeir virðast allir
skilja spumingamar á sama veg, þar sem þeir
eru annað hvort nær allir sammála eða allir
ósammála viðkomandi fullyrðingum eins
og sjá má á mynd. Þegar spumingunum er
beint að ákveðinni sérgrein eru svörin hjá
læknum í viðkomandi sérgrein einnig yfirleitt
afdráttarlaus. Það verður því ekki annað séð
en að rannsóknin sé marktæk að þessu leyti.
ÞAKKIR
Höfundar vilja færa þátttakendum í
könnuninni bestu þakkir. Rannsókn þessi var
gerð með styrk frá Rannsóknasjóði Háskóla
Islands.
SUMMARY
Non-Physical Territoriality in Health Care
Organizations in Iceland I.
Earlier studies on territories and territorial
behaviour have mainly dealt with physical
territories in man and animals. Recently, research
has also been focused on conceptual or non-
physical territoriality, based on groups with special
education, professions etc.
After 1970, there has been increased emphasis
on health care services outside hospitals in the
Nordic countries. GPs have received better pre-
and postgraduate education and new health centers
have been built. From that time holistic view,
continuity, comprehensiveness and community
based services have been the key words. Because
of this development GPs have taken over more
and more tasks which specialists in other fields of
medicine had before. This has led to conflicts and
debates about resources and groups of patients. A
study was carried out in Gothenburg 1986 with the
aim of developing and testing hypotheses on non-
physical territoriality in health care organizations
in Sweden. Similar studies were performed in the
other Nordic countries, and this survey deals with
the result from Iceland. A questionnaire with 65
statements and some background variables was
mailed to 185 physicians in seven specialities. The
total response rate was 81% ranging from 100%
for GPs to 63% for pediatricians. Professional
non-physical territories exist among different
categories of Icelandic physicians. GPs and oto-
laryngologists are usually on the strongest opposite
opinion especially regarding the need to direct
the flow of patients. There is also disagreement
between specialities regarding who should take care
of school health care, child- and matemity health
care. The results will be published in further detail
in four subsequent articles.
HEIMILDIR
1. Malmberg T. Human territoriality. Survey of
behavioural territories in man with preliminary
analysis and discussion of meaning. Great Britain:
Mouton publishers, 1980.
2. Malmberg T. Rakna med revir. Stockholm: Liber
Förlag, 1983.
3. Berggren L. Non-physical territoriality in health care
organizations. Doctoral Thesis. Department of Social
Medicine, Department of Environmental Hygiene,
University of Gothenburg 1986.
4. Blegren HM, Nylehn B. Organisationsteori.
Trondheim: Tapir, 1971.
5. Freidson E. The futures of professionalization. In:
Stacey M, Reid M, eds. Health and the Division of
labour. London: Neale Watson, Acad. Publs., 1977:
14-40.