Stubblefield Carol, Mutha Sunita
Jewish Hospital College of Nursing and Allied Health, 306 S. Kingshighway, St. Louis, MO 63110, USA.
J Allied Health. 2002 Summer;31(2):87-92.
Health care provider-patient role relationships can influence patient satisfaction, adherence to treatment, and health outcomes positively. Existing models of role relationships reflect one of three approaches to clinical management--paternalism, consumerism, or shared decision making. These models may or may not reflect the reality of chronic disease management in clinical practice. To characterize the nature of chronic disease management from the perspectives of primary care providers, we asked four nurse practitioners and four internists to describe the roles they saw for themselves and for their patients. A qualitative approach using a descriptive mode supported the formulation of a narrative description of these roles. The roles reflected a paternalistic approach to chronic disease management. The shared decision making approach supported in the literature was not evident. This finding is important for health professional education and practice.
医疗服务提供者与患者的角色关系能够对患者满意度、治疗依从性以及健康结果产生积极影响。现有的角色关系模型反映了临床管理的三种方法之一——家长式管理、消费主义或共同决策。这些模型可能反映也可能不反映临床实践中慢性病管理的实际情况。为了从初级保健提供者的角度描述慢性病管理的本质，我们请了四位执业护士和四位内科医生描述他们认为自己以及患者所扮演的角色。采用描述模式的定性方法有助于形成对这些角色的叙述性描述。这些角色反映了慢性病管理中的家长式管理方法。文献中所支持的共同决策方法并不明显。这一发现对卫生专业教育和实践具有重要意义。
