Nagl M, Ullrich A, Farin E
Abteilung Qualitätsmanagement und Sozialmedizin, Universitätsklinikum Freiburg, Engelbergerstraße 21, 79106 Freiburg.
Rehabilitation (Stuttg). 2013 Feb;52(1):34-9. doi: 10.1055/s-0032-1312664. Epub 2012 Jun 29.
An important requirement for achieving postulated goals in the context of patient education is that patient education be conducted in a way that the patients can understand it. It is the objective of this explorative study to examine how patients and providers evaluate the comprehensibility and patients' comprehension of patient education under routine conditions during orthopaedic rehabilitation. Furthermore, we aim to explore the influencing factors that patients and providers describe as conducive and counterproductive to the comprehensibility of patient education, and the ideas or desires they have as to how patient education can be made more comprehensible.
We conducted guided focus groups with 50 patients with chronic back pain or osteoarthritis aged between 22 and 71 years (M=50.4, SD=9.4) and 35 patient education providers aged between 26 and 61 years (M=44.9, SD=9.8) in a total of 9 orthopaedic rehabilitation centres. Qualitative analyses of the interview transcripts were conducted according to Mayring's content analytic approach using Atlas.ti software.
Patients and providers evaluate patient education as generally comprehensible. The involvement of patients in patient education is reported by both patients and providers as the main conducive factor. Patients describe poor (e. g. superficial or contradictory) information as counterproductive regarding comprehensibility, while providers tend to mention patients' lack of motivation and of taking personal responsibility as hindering patients' comprehension. Patients' and providers' proposals and ideas can be organized in the topics patient education (e. g. stronger reference to patients' everyday life), providers (e. g. improving providers' tutoring skills), information (e. g. more information), patient involvement (e. g. stronger consideration of patients' interests), organization (e. g. smaller groups), and goal clarification (e. g. consideration of patients' expectations).
Our results reveal that good comprehensibility can be achieved in patient education during routine orthopaedic rehabilitation. They also show the factors that account for good comprehensibility. The counterproductive factors described by patients and providers provide evidence of the factors that may hold potential for improving patient education with regard to comprehensibility.
在患者教育背景下实现既定目标的一项重要要求是，患者教育应以患者能够理解的方式进行。本探索性研究的目的是考察在骨科康复的常规条件下，患者和医护人员如何评估患者教育的可理解性以及患者对其的理解情况。此外，我们旨在探究患者和医护人员认为对患者教育可理解性有促进作用和不利作用的影响因素，以及他们对于如何使患者教育更易于理解的想法或愿望。
我们在总共9个骨科康复中心，对50名年龄在22至71岁之间（平均年龄50.4岁，标准差9.4岁）的慢性背痛或骨关节炎患者以及35名年龄在26至61岁之间（平均年龄44.9岁，标准差9.8岁）的患者教育提供者进行了有引导的焦点小组访谈。使用Atlas.ti软件，根据迈林的内容分析方法对访谈记录进行定性分析。
患者和医护人员认为患者教育总体上是可理解的。患者和医护人员都报告称，患者参与患者教育是主要的促进因素。患者认为信息不佳（如肤浅或相互矛盾）对可理解性有不利影响，而医护人员倾向于提及患者缺乏动力和个人责任感会阻碍患者理解。患者和医护人员的建议和想法可以归纳为以下主题：患者教育（如更多地提及患者的日常生活）、医护人员（如提高医护人员的辅导技能）、信息（如提供更多信息）、患者参与（如更多地考虑患者的兴趣）、组织（如小组规模更小）以及目标明确（如考虑患者的期望）。
我们的结果表明，在骨科康复的常规过程中，患者教育能够实现良好的可理解性。这些结果还揭示了实现良好可理解性的因素。患者和医护人员所描述的不利因素为在可理解性方面改善患者教育可能具有潜力的因素提供了证据。
