Robb Gillian, Seddon Mary
School of Population Health, University of Auckland, Private Bag 92019, Auckland.
N Z Med J. 2006 Sep 22;119(1242):U2174.
Patient-centred care is arguably the most important of the dimensions of quality as it is likely that a healthcare system which is patient-centred will also perform well against the other dimensions--safety as well as timely, accessible, effective, and efficient care. What does it mean to be patient-centred and how can it be achieved? This article explores several definitions of patient-centred care and discusses two interpretations--the expert patient and shared decision-making. Being sick is inherently a vulnerable position to be in and our current healthcare system does little to recognise and alleviate this vulnerability. But the patient-centred approach is about more than making the journey for patients less tortuous, it has actually been shown to improve outcomes. The evidence of benefit for a patient-centred approach is reviewed, along with some of the challenges in implementing the concept in practice.
以患者为中心的护理可以说是质量维度中最重要的，因为以患者为中心的医疗保健系统很可能在其他维度（安全以及及时、可及、有效和高效的护理）方面也表现出色。以患者为中心意味着什么，又如何实现呢？本文探讨了以患者为中心的护理的几种定义，并讨论了两种解释——专家患者和共同决策。生病本身就是一种内在的脆弱状态，而我们当前的医疗保健系统在认识和缓解这种脆弱性方面做得很少。但以患者为中心的方法不仅仅是让患者的就医过程不那么曲折，实际上它已被证明能改善治疗结果。本文回顾了以患者为中心的方法带来益处的证据，以及在实践中实施这一概念所面临的一些挑战。
