Institute for Policy Research and Innovation, University of Oregon, Eugene, OR 97403-5293, USA.
Health Expect. 2010 Mar;13(1):65-72. doi: 10.1111/j.1369-7625.2009.00571.x. Epub 2009 Nov 10.
Clinicians have been slow to embrace support for patient self-management.
To explore clinicians' beliefs about patient self-management and specifically assess which patient competencies clinicians believe are most important for their patients.
Using items adapted from the Patient Activation Measure (PAM) as a basis, a new measure that assesses clinicians' beliefs about patient self-management was created using Rasch analysis. The development and testing of the new measure Clinician Support for Patient Activation Measure (CS-PAM) is described here. Primary care clinicians from the UK and the USA were recruited to participate in the survey (n = 175).
The CS-PAM reliably measures clinician attitudes about the patient role in the care process. Clinicians strongly endorse that patients should follow medical advice but are less likely to endorse that patients should be able to make independent judgements or take independent actions. Endorsed to a lesser degree was the idea that patients should be able to function as a member of the care team. Least endorsed was the notion that patients should be independent information seekers.
Clinicians' views appear to be out of step with current policy directions and professional codes. Clinicians need support to transition to understand the need to support patients as independent actors.
临床医生一直不愿支持患者的自我管理。
探索临床医生对患者自我管理的信念,并特别评估他们认为对患者最重要的哪些患者能力。
使用患者激活量表(PAM)中的项目作为基础,使用 Rasch 分析创建了一种新的评估临床医生对患者自我管理信念的测量工具,即临床医生支持患者激活量表(CS-PAM)。本文介绍了该新测量工具的开发和测试。从英国和美国招募了初级保健临床医生参与调查(n=175)。
CS-PAM 可靠地衡量了临床医生对患者在护理过程中角色的态度。临床医生强烈赞同患者应该遵循医嘱,但不太可能赞同患者应该能够做出独立判断或采取独立行动。赞同患者应该能够作为护理团队的一员的程度较低。最不被认可的是患者应该是独立的信息寻求者的观点。
临床医生的观点似乎与当前的政策方向和专业准则不一致。临床医生需要支持来转变观念,认识到需要支持患者作为独立的行动者。