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促进社区健康老年人与药剂师之间的健康沟通:“问我三件事”项目。

Promoting health communication between the community-dwelling well-elderly and pharmacists: the Ask Me 3 program.

作者信息

Miller Michael J, Abrams Mary Ann, McClintock Barbara, Cantrell Matthew A, Dossett Corey D, McCleeary Erin M, McGee Meridith J, O'Keefe Kelly J, Sager Emily R

机构信息

Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma, Tulsa, OK 74135, USA.

出版信息

J Am Pharm Assoc (2003). 2008 Nov-Dec;48(6):784-92. doi: 10.1331/JAPhA.2008.07073.

Abstract

OBJECTIVE

To describe readiness to use clear health communication principles with a pharmacist before and after participating in the Ask Me 3 (What is my main problem?, What do I need to do?, Why is it important for me to do this?) program.

DESIGN

Modified, separate-sample, pretest-posttest study.

SETTING

Senior centers in Polk County, IA, between March 2006 and February 2007.

PARTICIPANTS

106 community-dwelling well-elderly.

INTERVENTION

Information on demographic characteristics, regularity of health care and medication use, health literacy level, and a measurement of multidimensional health locus of control were collected from participants, who were then were randomly allocated to one of three assessment subgroups: (1) pretest-posttest, (2) pretest only, and (3) posttest only during each of 12 Ask Me 3 program educational sessions.

MAIN OUTCOME MEASURE

Readiness to use the seven principles of clear health communication described in the Ask Me 3 program.

RESULTS

Participants were predominantly women and white, had a high school education or higher, had a yearly income of $25,000 or less, and had a mean age of 75.1 years. A majority reported good to excellent health status and visited their physician two or more times per year. All took medications regularly for a medical problem. A minority had inadequate to marginal health literacy. Before the Ask Me 3 program, a majority reported planning to or actively asking their pharmacist (1) for help with questions about their medications (88.2%), (2) to explain how to take their medication (82.6%), (3) to describe the main problem for which their medication is being prescribed (78.6%), and (4) to describe what can happen if they don't take their medication (74.3%). Approximately one-half of participants (55.2%) made a list of health or medication concerns to tell their pharmacist. A minority brought a list of current medications (47.8%) or brought a friend or family member to help when visiting their pharmacist (27.9%). A significantly higher proportion of participants reported planning to or actively bringing a list of current medications when visiting the pharmacist (P < or = 0.025) after participating in the Ask Me 3 program. Increases were not statistically significant for the remaining principles.

CONCLUSION

The Ask Me 3 program is a practical tool that creates awareness and reinforces principles of clear health communication. The Ask Me 3 program should be evaluated in diverse pharmacy and health care settings with patients at high risk for poor health communication.

摘要

目的

描述参与“问我三件事”(我的主要问题是什么?我需要做什么?为什么这样做对我很重要?)项目前后,老年人与药剂师进行清晰的健康沟通的意愿。

设计

改良的、独立样本的前后测研究。

地点

2006年3月至2007年2月期间,爱荷华州波尔克县的老年中心。

参与者

106名居住在社区的健康老年人。

干预措施

收集参与者的人口统计学特征、医疗保健和用药规律、健康素养水平以及多维健康控制点的测量数据,然后在12次“问我三件事”项目教育课程中的每次课程中,将他们随机分配到三个评估亚组之一:(1)前后测组,(2)仅前测组,(3)仅后测组。

主要观察指标

使用“问我三件事”项目中描述的清晰健康沟通七项原则的意愿。

结果

参与者主要为女性和白人,具有高中或更高学历,年收入为25,000美元或以下,平均年龄为75.1岁。大多数人报告健康状况良好至极佳,每年看医生两次或更多次。所有人都因医疗问题定期服药。少数人的健康素养不足或处于边缘水平。在“问我三件事”项目之前,大多数人报告计划或积极向药剂师(1)寻求有关药物问题的帮助(88.2%),(2)解释如何服药(82.6%),(3)描述开药的主要问题(78.6%),以及(4)描述如果不服药会发生什么(74.3%)。大约一半的参与者(55.2%)列出了健康或用药问题清单以告知药剂师。少数人携带了当前用药清单(47.8%)或在看药剂师时带朋友或家人帮忙(27.9%)。参与“问我三件事”项目后,报告计划或积极在看药剂师时携带当前用药清单的参与者比例显著更高(P≤0.025)。其余原则方面的增加无统计学意义。

结论

“问我三件事”项目是一个实用工具,可提高意识并强化清晰健康沟通的原则。应在健康沟通不良风险较高的患者的不同药房和医疗保健环境中对“问我三件事”项目进行评估。

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