Aaen Geest Tina, Wetzels Raymond, Wensing Michel, Cohen Castel Orit, Olesen Frede
Research Unit for General Practice, University of Aarhus, Aarhus, Denmark.
Eur J Gen Pract. 2006;12(1):3-9. doi: 10.1080/13814780600766253.
To implement a programme for involvement of older patients aged 70+ in general practice, and to detect quality changes after its implementation.
The study was performed in 11 European countries as an uncontrolled before-and-after study, in which a number of GPs and patients answered a questionnaire before and after receiving an intervention. The intervention was aimed at motivating, instructing and facilitating GPs and older patients to increase patient involvement during consultation by use of a specially designed consultation leaflet.
Valid data from seven countries exist. There was a total of 765 patients and 70 GPs in the pre-intervention phase, and 564 patients and 49 GPs in the post-intervention phase. In the post-intervention group, 43% of the patients thought that the consultation leaflet had improved the consultation and 62% of the GPs found it to be useful. There were no significant differences between pre- and post-intervention patient perceptions of the level of involvement, evaluations of consultations and perceptions of feeling enabled to deal with their health situation.
Quality of consultations as measured by patient satisfaction and patient enablement did not improve as a result of the intervention, but nearly half of the patients and two thirds of the GPs found the intervention to be useful. Unselected use of this intervention on all patients cannot be advised without further studies on possible effects. Future studies should focus on the applicability and benefits of the methods for special patient groups.
实施一项让70岁及以上老年患者参与全科医疗的项目，并在实施后检测质量变化。
该研究在11个欧洲国家进行，为一项非对照的前后对照研究，一些全科医生和患者在接受干预前后回答了一份问卷。干预旨在激励、指导和促进全科医生及老年患者通过使用一份专门设计的会诊传单，在会诊期间增加患者的参与度。
有来自七个国家的有效数据。干预前阶段共有765名患者和70名全科医生，干预后阶段有564名患者和49名全科医生。在干预后组中，43%的患者认为会诊传单改善了会诊，62%的全科医生认为它有用。干预前后患者对参与程度的认知、会诊评价以及对能够应对自身健康状况的认知之间没有显著差异。
以患者满意度和患者能力衡量的会诊质量并未因干预而提高，但近一半的患者和三分之二的全科医生认为干预有用。在未对可能的效果进行进一步研究之前，不建议对所有患者不加选择地使用这种干预措施。未来的研究应关注这些方法对特殊患者群体的适用性和益处。
