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相同的描述,不同的价值观。服务使用者和提供者如何定义医疗保健中的患者和公众参与。

Same description, different values. How service users and providers define patient and public involvement in health care.

机构信息

Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Health Expect. 2013 Sep;16(3):266-76. doi: 10.1111/j.1369-7625.2011.00713.x. Epub 2011 Aug 12.

Abstract

BACKGROUND

Patient and public involvement in health care is important, but the existing definitions of the concept do not integrate the stakeholders' own perceptions.

OBJECTIVE

To investigate and compare service users' and service providers' own definitions of patient and public involvement and their implications.

DESIGN, SETTING AND PARTICIPANTS: Qualitative study with mainly individual in-depth semi-structured interviews conducted between June 2007 and June 2009. Data were analysed using a grounded theory approach.

RESULTS

A total of 20 patients, 13 public representatives and 44 health service providers/managers in both somatic and mental health care were interviewed. A common definition of patient and public involvement emerged: It is founded on mutual respect, carried out through dialogue aiming at achieving shared decision making. Nevertheless, users and providers assigned different values to the core aspects: Respect was imperative for service users and implied for providers, dialogue was a way to gain respect for service users and to achieve good outcome for providers, and both worried that the other party wanted to make sole decisions.

CONCLUSIONS

Users and providers need to consider that although they have a common definition of involvement in health care, they assign different values to its aspects. Increasing and improving patient and public involvement therefore requires knowledge on and dialogue between the parties about these differences.

摘要

背景

患者和公众参与医疗保健非常重要,但现有概念的定义并未整合利益相关者的自身认知。

目的

调查和比较服务使用者和服务提供者对患者和公众参与的自身定义及其含义。

设计、地点和参与者:2007 年 6 月至 2009 年 6 月进行了一项定性研究,主要采用个体深入半结构化访谈。使用扎根理论方法分析数据。

结果

共采访了 20 名患者、13 名公众代表和 44 名来自躯体和精神卫生保健的卫生服务提供者/管理人员。出现了一个共同的患者和公众参与定义:它建立在相互尊重的基础上,通过对话进行,旨在实现共同决策。然而,使用者和提供者对核心方面赋予不同的价值:尊重对服务使用者来说是强制性的,对提供者来说则是隐含的,对话是服务使用者获得尊重和提供者实现良好结果的一种方式,双方都担心对方想要做出单方面的决策。

结论

使用者和提供者需要认识到,尽管他们对医疗保健中的参与有共同的定义,但他们对其方面赋予不同的价值。因此,增加和改善患者和公众参与需要各方了解和对话这些差异。

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