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骨关节炎的医疗保健提供:患者的期望与卫生专业人员认为他们应该拥有的之间的一致性。

Health care provision for osteoarthritis: concordance between what patients would like and what health professionals think they should have.

机构信息

North Bristol NHS Trust, Bristol, UK.

出版信息

Arthritis Care Res (Hoboken). 2011 Jul;63(7):963-72. doi: 10.1002/acr.20459.

Abstract

OBJECTIVE

To explore the opinions of patients and health professionals about the provision of health care for people with osteoarthritis (OA) and possible service improvements.

METHODS

Qualitative methods were used to explore the opinions of patients and health professionals about existing OA care and possible changes in service provision. Sixteen patients with hip or knee OA took part in focus groups, and 12 health professionals from primary and secondary care were interviewed. Focus groups and interviews were audio-recorded, transcribed, and anonymized. Transcripts were analyzed using the Framework method.

RESULTS

The views of the patients and health professionals generally concurred. They felt that OA should receive more attention and better consistency of care. More information and education about the condition, diet, exercise, aids, and resources was needed at the time of diagnosis. Patients wanted more time, better continuity, and proactive followup from general practitioners, with less variation in accessing joint replacement. Participants suggested access on demand to an "OA specialist" in primary care and the use of a management model comparable to other long-term conditions. Both patients and health professionals wanted better support for self-management to help patients manage their condition more effectively and appropriately.

CONCLUSION

Patients and health professionals perceived similar problems with OA care. More proactive care and improved information, especially for those with early OA, might achieve better outcomes. Access to a primary care OA specialist might provide better continuity of care, enable patients to meet their needs for information, support, and self-management, as well as improve appropriate referral to other resources.

摘要

目的

探讨患者和卫生专业人员对骨关节炎(OA)患者医疗服务的意见,以及可能的服务改进。

方法

采用定性方法探讨患者和卫生专业人员对现有 OA 护理的意见,以及服务提供可能的变化。16 名髋或膝关节 OA 患者参加了焦点小组,12 名来自初级和二级保健的卫生专业人员接受了访谈。对焦点小组和访谈进行了录音、转录和匿名处理。使用框架方法对记录进行分析。

结果

患者和卫生专业人员的观点大致相同。他们认为 OA 应该得到更多关注,护理的一致性应该更好。在诊断时,需要更多关于病情、饮食、运动、辅助器具和资源的信息和教育。患者希望从全科医生那里获得更多的时间、更好的连续性和主动随访,减少关节置换的差异。参与者建议在初级保健中按需获得“OA 专家”的访问,并采用与其他长期疾病类似的管理模式。患者和卫生专业人员都希望更好地支持自我管理,以帮助患者更有效地和恰当地管理他们的病情。

结论

患者和卫生专业人员对 OA 护理存在类似的问题。更积极主动的护理和改进信息,特别是对早期 OA 患者,可能会取得更好的效果。在初级保健中获得 OA 专家的访问可能会提供更好的连续性护理,使患者能够满足他们对信息、支持和自我管理的需求,并改善对其他资源的适当转诊。

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