Ruland C M
Case Western Reserve University, Cleveland, Ohio, USA.
J Am Med Inform Assoc. 1999 Jul-Aug;6(4):304-12. doi: 10.1136/jamia.1999.0060304.
While preference elicitation techniques have been effective in helping patients make decisions consistent with their preferences, little is known about whether information about patient preferences affects clinicians in clinical decision making and improves patient outcomes. The purpose of this study was to evaluate a decision support system for eliciting elderly patients' preferences for self-care capability and providing this information to nurses in clinical practice-specifically, its effect on nurses' care priorities and the patient outcomes of preference achievement and patient satisfaction.
Three-group quasi-experimental design with one experimental and two control groups (N = 151). In the experimental group computer-processed information about individual patient's preferences was placed in patients' charts to be used for care planning.
Information about patient preferences changed nurses' care priorities to be more consistent with patient preferences and improved patients' preference achievement and physical functioning. Further, higher consistency between patient preferences and nurses' care priorities was associated with higher preference achievement, and higher preference achievement with greater patient satisfaction.
This study demonstrated that decision support for eliciting patient preferences and including them in nursing care planning is an effective and feasible strategy for improving nursing care and patient outcomes.
虽然偏好诱导技术在帮助患者做出符合其偏好的决策方面很有效,但对于患者偏好信息是否会影响临床医生的临床决策并改善患者结局,我们知之甚少。本研究的目的是评估一种决策支持系统,该系统用于诱导老年患者对自我护理能力的偏好,并将此信息提供给临床实践中的护士——具体而言,评估其对护士护理优先级以及偏好达成的患者结局和患者满意度的影响。
三组准实验设计,包括一个实验组和两个对照组(N = 151)。在实验组中,有关个体患者偏好的计算机处理信息被放入患者病历中,以供护理计划使用。
患者偏好信息改变了护士的护理优先级,使其更符合患者偏好,并改善了患者的偏好达成情况和身体功能。此外,患者偏好与护士护理优先级之间更高的一致性与更高的偏好达成相关,而更高的偏好达成与更高的患者满意度相关。
本研究表明,诱导患者偏好并将其纳入护理计划的决策支持是改善护理和患者结局的有效且可行的策略。