银屑病患者的医疗保健与实际需求分析：一项针对意大利人群的调查
Analysis of health care and actual needs of patients with psoriasis: a survey on the Italian population.
作者信息
Altobelli Emma, Maccarone Mara, Petrocelli Reimondo, Marziliano Ciro, Giannetti Alberto, Peris Ketty, Chimenti Sergio
机构信息
Department of Internal Medicine and Public Health, University of L'Aquila, Coppito-Delta 6, 67100 L'Aquila, Italy.
出版信息
BMC Public Health. 2007 Apr 21;7:59. doi: 10.1186/1471-2458-7-59.
BACKGROUND
Over recent years the public health system has shown increasing interest in patients' views for use as guideline criteria in evaluating the quality of assistance above all for those patients with chronic diseases. Hence the interest in psoriasis, which is a chronic disease frequently associated with diabetes mellitus, hypertension, obesity, and cardiovascular diseases. The aims of our study were to describe clinic characteristics of patients with psoriasis, the quality of the assistance perceived by patients arrived at outpatients clinics and the information received, in order to identify areas in Italy requiring improvement.
METHODS
1954 patients, aged between 18 and 85 years, were consecutively enrolled at outpatients clinics across 21 Italian provinces over the period December 2004-January 2006. A standardized questionnaire was developed in collaboration with an Italian Association of Psoriatic Patients (A.DI.PSO) and tested in a pilot study. The questionnaire was divided into three sections: the first section included social, demographic and individual variables; the second concerned the quality of the assistance perceived by the patients at public dermatologic clinics and the third focused on the need of information requirements of patients with psoriasis. The chi2 test was used to estimate the association between the categorical variables under study. Kruskal-Wallis test was applied to the interval and ordinal variables.
RESULTS
The presence of psoriatic arthritis was reported in 26.0% of patients. Associated chronic diseases included depression (15.4%), hypertension (13.3%), obesity (8.9%) and type 2 diabetes mellitus (7.3%). The study highlighted the need of improvements of health care services at public dermatologic clinics especially in overcoming architectonic barriers and reducing appointment wait-times, particularly in South Italy. However, patients reported a positive relationship with Health System employers due to the confidentiality. This positive impression was confirmed by the observation that dermatologists were considered the best source of information about therapies on psoriasis.
CONCLUSION
Our study allowed to identify critical aspects which could be tackled through initiatives with the aim of improving these emerged needs.
背景
近年来，公共卫生系统越来越关注患者的观点，将其作为评估医疗服务质量的指导标准，尤其是对于那些患有慢性病的患者。因此，对银屑病产生了兴趣，银屑病是一种经常与糖尿病、高血压、肥胖症和心血管疾病相关的慢性病。我们研究的目的是描述银屑病患者的临床特征、到门诊就诊的患者所感受到的医疗服务质量以及所获得的信息，以便确定意大利需要改进的领域。
方法
2004年12月至2006年1月期间，在意大利21个省份的门诊连续招募了1954名年龄在18至85岁之间的患者。与意大利银屑病患者协会（A.DI.PSO）合作制定了一份标准化问卷，并在一项试点研究中进行了测试。问卷分为三个部分：第一部分包括社会、人口统计学和个人变量；第二部分涉及患者在公共皮肤科诊所所感受到的医疗服务质量，第三部分关注银屑病患者的信息需求。使用卡方检验来估计所研究的分类变量之间的关联。对区间变量和有序变量应用Kruskal-Wallis检验。
结果
26.0%的患者报告患有银屑病关节炎。相关的慢性病包括抑郁症（15.4%）、高血压（13.3%）、肥胖症（8.9%）和2型糖尿病（7.3%）。该研究强调了公共皮肤科诊所改善医疗服务的必要性，特别是在克服建筑障碍和减少预约等待时间方面，尤其是在意大利南部。然而，由于保密性，患者报告与医疗系统工作人员关系良好。皮肤科医生被认为是关于银屑病治疗信息的最佳来源，这一观察结果证实了这种积极印象。
结论
我们的研究能够确定关键方面，可通过采取举措来解决这些问题，以满足出现的需求。
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