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患者参与卫生服务规划与评估的障碍:一项探索性研究。

Barriers to patient involvement in health service planning and evaluation: an exploratory study.

作者信息

Gagliardi Anna R, Lemieux-Charles Louise, Brown Adalsteinn D, Sullivan Terrence, Goel Vivek

机构信息

Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room C8-30, Toronto, Ontario, Canada M4N3M5.

出版信息

Patient Educ Couns. 2008 Feb;70(2):234-41. doi: 10.1016/j.pec.2007.09.009. Epub 2007 Nov 26.

DOI:10.1016/j.pec.2007.09.009
PMID:18023129
Abstract

OBJECTIVE

Patient involvement in health service planning and evaluation is considered important yet not widely practiced. This study explored stakeholder beliefs about patient participation in performance indicator selection to better understand hypothesized barriers.

METHODS

Interviews with 30 cancer patients and health professionals from two teaching hospitals were analyzed qualitatively.

RESULTS

All groups believed patients, not members of the public, should be involved in the selection of indicators. Ongoing, interactive methods such as committee involvement, rather than single, passive efforts such as surveys were preferred. Health professionals recommended patients assume a consultative, rather than decision-making role. Older patients agreed with this.

CONCLUSION

Variable patient interest, health professional attitudes, and a lack of insight on appropriate methods may be limiting patient involvement in this, and other service planning and evaluation activities. More research is required to validate expressed views among the populations these stakeholders represent, and to establish effective methods for engaging patients.

PRACTICE IMPLICATIONS

Efforts to encourage a change in health professional attitude may be required, along with dedicated organizational resources, coordinators and training. Methods to engage patients should involve deliberation, which can be achieved through modified Delphi panel or participatory research approaches.

摘要

目的

患者参与卫生服务规划与评估被认为很重要,但实践并不广泛。本研究探讨了利益相关者对患者参与绩效指标选择的看法,以更好地理解假设的障碍。

方法

对来自两家教学医院的30名癌症患者和卫生专业人员进行访谈,并进行定性分析。

结果

所有群体都认为应该让患者而非公众参与指标选择。比起单一、被动的方式(如调查),更倾向于采用持续的互动方式(如委员会参与)。卫生专业人员建议患者承担咨询角色而非决策角色。老年患者对此表示认同。

结论

患者兴趣各异、卫生专业人员态度以及对合适方法缺乏了解,可能限制了患者参与此项及其他服务规划与评估活动。需要更多研究来验证这些利益相关者所代表人群表达的观点,并建立让患者参与的有效方法。

实践意义

可能需要努力鼓励卫生专业人员改变态度,同时配备专门的组织资源、协调人员和培训。让患者参与的方法应包括审议,这可通过改进的德尔菲小组或参与式研究方法来实现。

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