Doherty Carole, Doherty Warren
Worcestershire Acute Hospitals NHS Trust, Worcester, UK.
J Nurs Manag. 2005 Mar;13(2):119-27. doi: 10.1111/j.1365-2934.2004.00498.x.
The research aimed to identify what involvement patients want in clinical decision-making and explore the underlying factors influencing that choice, thus identifying aids and barriers to increasing patients' involvement in decision-making. The study design was inspired by interpretative phenomenology, thus the framework for analysis is intended to aid interpretation and comprehension of the patients' experiences and understanding through identifying similarities and differences in their stories. Data were collected through semi-structured interviews of twenty people who were patients in a secondary care milieu at the time of interview. Results showed that, 20% of patients chose an active role in decision-making and 80% chose a collaborative or a passive role. However what people selected on the autonomy preference index was not always reflected in the interview. Additionally, the findings suggest that the NHS maintains a paternalistic approach. Lack of staff, lack of information and poor continuity of care with nursing staff made patients feel disempowered.
该研究旨在确定患者希望在临床决策中参与到何种程度，并探究影响这一选择的潜在因素，从而找出促进或阻碍患者更多参与决策的因素。该研究设计受解释现象学启发，因此分析框架旨在通过识别患者故事中的异同，辅助对患者经历和理解的解释与理解。数据通过对20名在访谈时处于二级护理环境中的患者进行半结构化访谈收集。结果显示，20%的患者选择在决策中发挥积极作用，80%的患者选择协作或被动角色。然而，人们在自主性偏好指数上的选择并不总是在访谈中得到体现。此外，研究结果表明，英国国民医疗服务体系（NHS）保持着家长式作风。人员短缺、信息匮乏以及与护理人员护理连续性差，使患者感到无权。
