Health Communication Program, RTI International, 3040 Cornwallis Road, RTP, NC 27709, USA.
Soc Sci Med. 2011 Apr;72(7):1085-95. doi: 10.1016/j.socscimed.2011.01.020. Epub 2011 Mar 4.
Patient-centered communication (PCC) is a critical element of patient-centered care, which the Institute of Medicine (Committee on Quality of Health Care in America, 2001) promulgates as essential to improving healthcare delivery. Consequently, the US National Cancer Institute's Strategic Plan for Leading the Nation (2006) calls for assessing the delivery of PCC in cancer care. However, no comprehensive measure of PCC exists, and stakeholders continue to embrace different conceptualizations and assumptions about how to measure it. Our approach was grounded in the PCC conceptual framework presented in a recent US National Cancer Institute monograph (Epstein & Street, 2007). In this study, we developed a comprehensive inventory of domains and subdomains for PCC by reviewing relevant literature and theories, interviewing a limited number of cancer patients, and consulting experts. The resulting measurement domains are organized under the six core functions specified in the PCC conceptual framework: exchanging information, fostering healing relationships, recognizing and responding to emotions, managing uncertainty, making decisions, and enabling patient self-management. These domains represent a promising platform for operationalizing the complicated PCC construct. Although this study focused specifically on cancer care, the PCC measurements are relevant to other clinical contexts and illnesses, given that patient-centered care is a goal across all healthcare. Finally, we discuss considerations for developing PCC measures for research, quality assessment, and surveillance purposes. United States Department of Health and Human Services, National Institutes of Health, National Cancer Institute (2006). The NCI Strategic Plan for Leading the Nation: To Eliminate the Suffering and Death Due to Cancer. NIH Publication No. 06-5773.
以患者为中心的沟通（PCC）是以患者为中心的护理的关键要素，美国医学研究所（委员会对医疗质量在美国，2001 年）颁布为改善医疗服务的提供至关重要。因此，美国国家癌症研究所的战略计划领导国家（2006 年）呼吁评估在癌症护理中提供以患者为中心的护理。然而，不存在全面的 PCC 衡量标准，利益相关者继续对如何衡量它有不同的概念化和假设。我们的方法基于最近美国国家癌症研究所专着中提出的 PCC 概念框架（Epstein & Street，2007 年）。在这项研究中，我们通过审查相关文献和理论、采访有限数量的癌症患者以及咨询专家，开发了一个全面的 PCC 领域和子领域清单。由此产生的测量领域是根据 PCC 概念框架中规定的六个核心功能组织的：交换信息、培养治疗关系、识别和响应情绪、管理不确定性、做出决策和促进患者自我管理。这些领域代表了实现复杂 PCC 结构的有希望的平台。虽然这项研究专门针对癌症护理，但鉴于以患者为中心的护理是所有医疗保健的目标，因此 PCC 测量与其他临床环境和疾病相关。最后，我们讨论了为研究、质量评估和监测目的开发 PCC 措施的考虑因素。美国卫生与公众服务部，美国国立卫生研究院，美国国家癌症研究所（2006 年）。NCI 领导国家战略计划：消除癌症引起的痛苦和死亡。NIH 出版物号 06-5773。
