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观察者报告与患者调查报告中药师沟通行为的一致性。

Concordance between observer reports and patient survey reports of pharmacists' communication behaviors.

机构信息

Division of Pharmaceutical Sciences, Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, NY 11201, USA.

出版信息

Res Social Adm Pharm. 2011 Sep;7(3):272-80. doi: 10.1016/j.sapharm.2010.07.001. Epub 2011 Mar 3.

Abstract

BACKGROUND

Assessing the quantity and quality of pharmacist-patient communication is important to create strategies for improving communication. Findings from studies on pharmacist-patient communication differ on the extent of communication by pharmacists. This disagreement could be because of different methods of data collection, samples, and concepts used to measure communication.

OBJECTIVES

This research compared findings from 2 widely used methods of data collection (survey and observation) to identify: (1) the extent to which pharmacists ask questions to patients and provide information on directions, side effects, and adverse effect, (2) agreement between observation and patient report data on pharmacist information giving and question asking, and (3) how patient perceptions of question asking vary according to the structure of the question asked.

METHODS

A cross-sectional fieldwork design was used to collect data from a stratified random sample of 30 community pharmacies in Southeast and South-central Wisconsin. At each pharmacy, the dispensing pharmacist and 12 patients filling prescriptions were recruited. Each patient was observed for their interaction with the pharmacist and completed a survey while exiting the pharmacy. Both the survey and the observation tool consisted of items pertaining to recording of pharmacist information provision related to direction, side effects, and interactions, and pharmacist's question-asking behaviors. Descriptive analyses and correlations are reported.

RESULTS

There was good agreement between the 2 methods regarding pharmacist information provision behaviors (r=0.091, P<.001), this was less true of question asking (r=0.28, P=.034). Certain types of questions showed greater concordance with the observed pharmacist questions. Patients were less likely to report having been asked a question when it took the form of a nonspecific closed-ended questions, that is, "Do you have any questions?"

CONCLUSIONS

One of the most frequent questions pharmacists ask patients may not be either remembered or perceived by patients as a serious question, let alone an invitation to raise a concern. Secondly, during the selection of a specific method of data collection, researchers need to weigh strengths and weaknesses of various methods. Multimethod studies are encouraged.

摘要

背景

评估药师与患者沟通的数量和质量对于制定沟通策略非常重要。药师沟通程度的研究结果存在差异,这可能是由于数据收集方法、样本和用于衡量沟通的概念不同。

目的

本研究比较了两种广泛使用的数据收集方法(调查和观察)的结果,以确定:(1)药师向患者提问并提供用药指导、副作用和不良反应信息的程度;(2)观察结果与患者报告的药师信息提供和提问数据之间的一致性;(3)根据问题结构的不同,患者对提问的看法差异。

方法

采用横断面现场设计,从威斯康星州东南部和中南部的 30 家社区药店中抽取分层随机样本收集数据。在每家药店,招募配药药师和 12 名正在配药的患者。对每位患者与药师的互动进行观察,并在离开药店时完成一项调查。调查和观察工具均包含与记录药师提供用药指导、副作用和交互作用相关的信息以及药师提问行为相关的项目。报告描述性分析和相关性。

结果

在药师信息提供行为方面,两种方法之间存在良好的一致性(r=0.091,P<.001),但在提问行为方面则不然(r=0.28,P=.034)。某些类型的问题与观察到的药师问题更一致。当问题形式为非特定的封闭式问题,例如“您有任何问题吗?”时,患者更不可能报告被问到问题。

结论

药师最常问患者的问题之一可能既未被患者记住,也未被患者视为严肃的问题,更不用说邀请患者提出关注。其次,在选择特定的数据收集方法时,研究人员需要权衡各种方法的优缺点。鼓励采用多方法研究。

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