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系统性硬化症患者对医疗服务的需求和偏好。

Needs and preferences regarding health care delivery as perceived by patients with systemic sclerosis.

机构信息

Department of Rheumatology, C-01-Q, Leiden University Medical Center, 2300, RC, Leiden, The Netherlands.

出版信息

Clin Rheumatol. 2011 Jun;30(6):815-24. doi: 10.1007/s10067-010-1645-6. Epub 2011 Jan 18.

Abstract

This study aims to examine the needs and preferences regarding the delivery of health care services and information provision and their determinants in patients with systemic sclerosis (SSc). A questionnaire was sent to 77 SSc outpatients, comprising 27 items on health care needs within the domains physical, psychological, social support, employment/daily activities, or other health problems and 13 items on information needs. Moreover, the patients' preferences regarding the provision of health care services and information were listed. Additional assessments included sociodemographic characteristics, physical functioning (SSc Health Assessment Questionnaire), and quality of life (SF-36). Sixty-four patients (83%) returned the questionnaire. Twenty-six patients (41%) reported one or more unmet health care needs, with the highest proportions of patients with unmet needs seen in the physical (28%) and psychological (20%) domain. The highest percentages of patients with information needs were observed for medical subjects (20-28%). A lower mental component summary scale score and younger age were associated with the presence of at least one health care need in the psychological domain. Worse physical functioning, a diagnosis of diffuse SSc and having a partner were associated with higher information need score. A yearly, standardized multidisciplinary assessment program was most frequently mentioned as a preferred, but not yet existing health care model (59%) and the rheumatologist as a preferred source of information supply (75%). Unmet health care and information needs are common among SSc patients. To improve SSc health care, more attention should be paid to health care services for specific physical and psychological problems and medical information supply by the rheumatologist. In addition, the development of new models of care, such as a yearly, standardized multidisciplinary diagnostic program seems warranted.

摘要

本研究旨在探讨系统性硬化症(SSc)患者对医疗服务和信息提供的需求和偏好,以及这些需求和偏好的决定因素。我们向 77 名 SSc 门诊患者发送了一份问卷,其中包含 27 个关于身体、心理、社会支持、就业/日常活动或其他健康问题领域的医疗需求项目,以及 13 个关于信息需求的项目。此外,列出了患者对医疗服务和信息提供的偏好。额外的评估包括社会人口统计学特征、身体功能(SSc 健康评估问卷)和生活质量(SF-36)。64 名患者(83%)返回了问卷。26 名患者(41%)报告存在一种或多种未满足的医疗需求,其中身体(28%)和心理(20%)领域未满足需求的患者比例最高。在信息需求方面,有最高比例的患者需要医学主题(20-28%)。心理领域至少存在一种医疗需求的患者中,心理成分综合评分较低和年龄较小的比例较高。身体功能越差、弥漫性 SSc 诊断和有伴侣与更高的信息需求评分相关。每年进行一次标准化的多学科评估方案是最常被提及的首选但尚未存在的医疗模式(59%),而风湿病学家是首选的信息供应来源(75%)。未满足的医疗和信息需求在 SSc 患者中很常见。为了改善 SSc 的医疗保健,应更加关注特定身体和心理问题的医疗服务以及风湿病学家提供的医学信息供应。此外,似乎需要开发新的护理模式,例如每年进行标准化的多学科诊断方案。

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