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老年人对参与自身护理的偏好:一项针对11个欧洲国家初级卫生保健的定性研究。

Older people's preferences for involvement in their own care: a qualitative study in primary health care in 11 European countries.

作者信息

Bastiaens Hilde, Van Royen Paul, Pavlic Danica Rotar, Raposo Victor, Baker Richard

机构信息

Department of General Practice (S5), University of Antwerp, Universiteitsplein 1, 2600 Wilrijk, Belgium.

出版信息

Patient Educ Couns. 2007 Sep;68(1):33-42. doi: 10.1016/j.pec.2007.03.025. Epub 2007 Jun 1.

Abstract

OBJECTIVE

The aim of the study was to explore the views of people aged over 70 years on involvement in their primary health care in 11 different European countries.

METHODS

Older patients were asked about their views on patient involvement in a face-to-face interview. All interviews were audio-recorded, transcribed and analysed in accordance with the principles of 'qualitative content analysis'. An international code list was used.

RESULTS

Four hundred and six primary care patients aged between 70 and 96 years were interviewed. Their views could be categorized into four major groups: doctor-patient interaction, GP related topics, patient related issues and contextual factors.

CONCLUSION

People over 70 do want to be involved in their care but their definition of involvement is more focussed on the 'caring relationship', 'person-centred approach' and 'receiving information' than on 'active participation in decision making'.

PRACTICE IMPLICATIONS

The desire for involvement in decision making is highly heterogeneous so an individual approach for each patient in the ageing population is needed. Future research and medical education should focus on methods and training to elicit older patients' preferences. The similar views in 11 countries suggest that methods for enhancing patient involvement in older people could be internationally developed and exchanged.

摘要

目的

本研究旨在探讨11个不同欧洲国家中70岁以上人群对参与初级医疗保健的看法。

方法

通过面对面访谈询问老年患者对患者参与的看法。所有访谈均进行录音、转录,并按照“定性内容分析”原则进行分析。使用了国际代码列表。

结果

对406名年龄在70至96岁之间的初级保健患者进行了访谈。他们的观点可分为四大类:医患互动、与全科医生相关的话题、与患者相关的问题以及背景因素。

结论

70岁以上的人确实希望参与自身护理,但他们对参与的定义更多地集中在“关怀关系”“以人为本的方法”和“接收信息”上,而非“积极参与决策”。

实践意义

参与决策的愿望差异很大,因此需要针对老年人群体中的每位患者采取个性化方法。未来的研究和医学教育应侧重于引出老年患者偏好的方法和培训。11个国家的相似观点表明,可以在国际上开发和交流增强老年人患者参与度的方法。

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