Cho Alex H, Voils Corrine I, Yancy William S, Oddone Eugene Z, Bosworth Hayden B
Center for Health Services Research in Primary Care, Vetterans Affairs Medical Center, Durham, NC 27705, USA.
J Clin Hypertens (Greenwich). 2007 May;9(5):330-6. doi: 10.1111/j.1524-6175.2007.06489.x.
This study examined patients' perceptions of their providers' participatory decision making (PDM) style and hypertension self-care behaviors and outcomes. Five hundred fifty-four veterans with hypertension enrolled in the Veterans' Study to Improve the Control of Hypertension rated providers' PDM styles using a validated 3-item instrument. Behaviors assessed included presence of a home blood pressure monitor, monitoring frequency, and self-reported antihypertensive medication adherence. Overall, veterans with hypertension rated providers as highly participatory. In adjusted analyses, a lower PDM score was associated with decreased odds of having a home monitor (odds ratio, 0.90 per 10-point decrement in PDM score; 95% confidence interval, 0.83-0.98) but not with monitoring frequency, adherence, or blood pressure control. Providers' involvement of patients in decision making, reflected in ratings of PDM style, may be important to securing patients' participation in their own care, but alone this factor seems insufficient. No relationship between PDM score and blood pressure control was observed.
本研究考察了患者对其医疗服务提供者参与式决策（PDM）风格以及高血压自我护理行为和结果的看法。554名患有高血压的退伍军人参与了“改善高血压控制退伍军人研究”，他们使用经过验证的3项工具对医疗服务提供者的PDM风格进行评分。评估的行为包括是否拥有家用血压监测仪、监测频率以及自我报告的抗高血压药物依从性。总体而言，患有高血压的退伍军人将医疗服务提供者评为高度参与式。在调整分析中，较低的PDM评分与拥有家用监测仪的几率降低相关（PDM评分每降低10分，比值比为0.90；95%置信区间为0.83 - 0.98），但与监测频率、依从性或血压控制无关。医疗服务提供者让患者参与决策，这在PDM风格评分中有所体现，对于确保患者参与自身护理可能很重要，但仅这一因素似乎并不充分。未观察到PDM评分与血压控制之间的关系。
