Costa F P C A, Duggan C, van Mil J W F
Centre for Pharmacoepidemiological Research, National Association of Pharmacies, R. Marechal Saldanha, 1, 1249-069 Lisbon, Portugal.
Pharm World Sci. 2004 Dec;26(6):313-8. doi: 10.1007/s11096-004-9007-6.
To measure patients' perceptions of their care needs, by developing a tool to assess these needs and evaluate its utility in community pharmacy practice.
A survey tool comprising 37 items was developed to assess asthmatic patients' perceptions of their health-related needs, using data from literature reviews and expert opinions. The tool was piloted on 25 patients to ensure the content of the questionnaire was valid. Changes were made following piloting and the modified tool was then tested in the main study, on 101 patients from thirteen community pharmacies in Portugal. Data from this phase were subjected to factor analysis and reliability testing.
118 asthmatic patients were recruited, of which 101 questionnaires were eligible for analysis. From these, 40 were male (39.6%) and 61 were female (60.4%). The mean age of respondents was 41 years (sd = 19.02). The first changes made to the survey tool included the adding of items relevant to patients recruited in the pilot and the simplification of the scaling used. The survey tool was then subjected to factor analysis and reliability testing. Six scales emerged, which described the need for GP support, specialist support, pharmacist support, nurse support, other carers' support and written support. Internal consistency was good (Cronbach's coefficient alpha ranged from 0.81 to 0.93). Although there were no significant associations between educational level and other factors, other attributes influenced the communication between pharmacist and physician (chi2 = 6.972; P = 0.031). Patients with a lower level of education (up to six years) valued communication between these two professionals more than among patients with higher education. The patient's age group was associated with an expressed need for explanation of inhaler technique (chi2 = 6.494; P = 0.039). There was extended need in both oldest and youngest patients. There was a significant difference between high and low scorers to the factor 'pharmacist's role in asthma' (F1) and patients treated by either specialist or GP (chi2 = 4.935; P = 0.026). There were differences between those who were bothered by their asthma or not and their perceptions of 'Pharmacist's ideal role in asthma' (F1 & 3) (chi2 = 5.967; P = 0.051).
The tool needs further development to ensure its validity and utility in practice. This will provide greater insight into patients' perceptions of their healthcare needs, which can allow health professionals to target their interventions. Such a tool may then be used in pharmacies that intend to change their current practice, to raise pharmacists' awareness of patients' demands. Developing ways to meet those needs will ultimately lead to an increased quality service and therefore 'client' satisfaction.
通过开发一种工具来评估患者的护理需求，并评估其在社区药房实践中的效用，以衡量患者对自身护理需求的认知。
利用文献综述和专家意见中的数据，开发了一个包含37个条目的调查工具，以评估哮喘患者对其健康相关需求的认知。该工具在25名患者中进行了预试验，以确保问卷内容的有效性。预试验后进行了修改，然后在主要研究中对来自葡萄牙13家社区药房的101名患者进行了测试。对这一阶段的数据进行了因子分析和信度测试。
招募了118名哮喘患者，其中101份问卷符合分析条件。其中，男性40名（39.6%），女性61名（60.4%）。受访者的平均年龄为41岁（标准差=19.02）。对调查工具的首次修改包括增加与预试验中招募的患者相关的条目，以及简化所用的量表。然后对调查工具进行了因子分析和信度测试。出现了六个量表，分别描述了对全科医生支持、专科医生支持、药剂师支持、护士支持、其他护理人员支持和书面支持的需求。内部一致性良好（克朗巴哈系数α范围为0.81至0.93）。虽然教育水平与其他因素之间没有显著关联，但其他属性影响了药剂师与医生之间的沟通（χ²=6.972；P=0.031）。教育水平较低（最高六年）的患者比受过高等教育的患者更重视这两个专业人员之间的沟通。患者的年龄组与对吸入器技术解释的需求表达相关（χ²=6.494；P=0.039）。最年长者和最年轻者都有额外的需求。在“药剂师在哮喘中的作用”因子（F1）得分高和低的患者之间，以及由专科医生或全科医生治疗的患者之间存在显著差异（χ²=4.935；P=0.026）。受哮喘困扰与否的患者对“药剂师在哮喘中的理想作用”（F1和3）的认知存在差异（χ²=5.967；P=0.051）。
该工具需要进一步开发，以确保其在实践中的有效性和实用性。这将更深入地了解患者对其医疗保健需求的认知，从而使卫生专业人员能够针对性地进行干预。这样的工具可用于有意改变当前做法的药房，以提高药剂师对患者需求的认识。开发满足这些需求的方法最终将提高服务质量，从而提高“客户”满意度。
