Elder Nancy C, Barney Kelley
Department of Family and Community Medicine, University of Cincinnati, USA.
Jt Comm J Qual Patient Saf. 2012 Apr;38(4):168-76. doi: 10.1016/s1553-7250(12)38022-7.
The best ways to communicate test results in primary care to achieve patient satisfaction and assist patients to incorporate results into their personal health decision making are unknown. A study was conducted to determine the factors that patients believe are important in achieving those goals.
Semistructured interviews were conducted with a convenience sample of 12 adults, at least half with a chronic disease requiring regular testing, who shared experiences about receiving test results from physicians' offices and how they used them in their health decision making. In addition, "think aloud" interviewing techniques were used to assess participants' satisfaction and stated understanding with six different formats for receiving a hypothetical test result (a mildly elevated lipid profile). The interviews were analyzed using the editing technique to determine important factors in test results notification.
Three themes were found to be important in satisfaction with and stated understanding and use of test results: (1) the information shared (test result, clinician interpretation and guidance), (2) significance of the results (testing purpose, abnormal or normal result) and (3) personal preferences for communication (timeliness, interpersonal connection, and hard copy). Participants' stated understanding was highest, among several potential formats, for actual values with desired/normal values, a low-literacy description of the test's purpose, and a simple graph.
A results notification algorithm includes (1) communication elements (the purpose of the test, the actual results with desired values, clinician guidance, and a graphical representation) and (2) appropriate choice of notification technique (phone/visit for diagnostic tests and all significantly abnormal results and mail/e-mail/Web for all others).
在初级保健中传达检查结果以实现患者满意度并帮助患者将结果纳入个人健康决策的最佳方法尚不清楚。开展了一项研究以确定患者认为对实现这些目标很重要的因素。
对12名成年人的便利样本进行了半结构化访谈，其中至少一半患有需要定期检查的慢性病，他们分享了从医生办公室收到检查结果的经历以及他们如何在健康决策中使用这些结果。此外，采用“边想边说”的访谈技巧来评估参与者对六种不同格式接收假设检查结果（轻度升高的血脂水平）的满意度和陈述的理解。使用编辑技术对访谈进行分析，以确定检查结果通知中的重要因素。
发现三个主题对于对检查结果的满意度、陈述的理解和使用很重要：（1）共享的信息（检查结果、临床医生的解释和指导），（2）结果的重要性（检查目的、异常或正常结果）以及（3）沟通的个人偏好（及时性、人际联系和纸质副本）。在几种潜在格式中，参与者对实际值与期望/正常值、对检查目的的低识字率描述以及简单图表的陈述理解最高。
结果通知算法包括（1）沟通要素（检查目的、带有期望值的实际结果、临床医生指导和图形表示）以及（2）通知技术的适当选择（诊断检查和所有明显异常结果通过电话/就诊，其他所有结果通过邮件/电子邮件/网络）。
