Health Psychology Department, Universidad Miguel Hernández, Elche, Spain; Sexual and Reproductive Health, Centro Salud Hospital-Pla, Alicante, Spain.
Health Expect. 2014 Dec;17(6):826-39. doi: 10.1111/j.1369-7625.2012.00809.x. Epub 2012 Aug 17.
There are doubts on whether patients feel that they have sufficient information for actively participating in clinical decisions.
To describe the type of information that patients receive. To determine whether patients consider this information sufficient, and whether it contributes or not to improve clinical safety. To identify the barriers for patient participation in clinical decision making.
Cross-sectional study with 764 patients and 327 physicians.
Fourteen health centres belonging to three primary care districts and three hospitals in Spain.
Just 35.1% (268) (95% CI 32.2, 39.1%) of patients preferred to have the last word in clinical decisions. Age (39 vs. 62%, P < 0.001) and severity of illness (38 vs. 46%, P = 0.002) increased the tendency to take a passive role. In 85.1% (650) (95% CI 83.3, 88.3%) of the cases, patients reported having received sufficient information. Lack of consultation time (29.6%, 95% CI 25.8, 32.5%) and patients' use of Internet or other sources (19.2%, 95% CI 16.4, 22.2%) were identified as new obstacles to doctor-patient communication by the patients. Only 19.6% (64) (95% CI 15.4, 24.2%) of doctors considered that they could intervene to involve patients in the decisions.
The majority of patients prefer the decisions to be made by their doctor, especially those with more severe illnesses, and older patients. Patients are not normally informed about medication interactions, precautions and foreseeable complications. The information provided by general practitioners does not seem to contribute enough to the patient involvement in clinical safety.
人们对患者是否认为自己获得了足够的信息以积极参与临床决策存在疑虑。
描述患者所获得的信息类型。确定患者是否认为这些信息足够，并确定其是否有助于提高临床安全性。识别患者参与临床决策制定的障碍。
一项包含 764 名患者和 327 名医生的横断面研究。
西班牙三个初级保健区的 14 个卫生中心和 3 家医院。
只有 35.1%（268 人）（95%CI 32.2%，39.1%）的患者希望在临床决策中拥有最终决定权。年龄（39 岁比 62%，P<0.001）和疾病严重程度（38 岁比 46%，P=0.002）增加了被动参与的倾向。在 85.1%（650 人）（95%CI 83.3%，88.3%）的情况下，患者报告说他们获得了足够的信息。缺乏咨询时间（29.6%，95%CI 25.8%，32.5%）和患者使用互联网或其他来源（19.2%，95%CI 16.4%，22.2%）被患者视为医患沟通的新障碍。只有 19.6%（64 人）（95%CI 15.4%，24.2%）的医生认为他们可以干预以促使患者参与决策。
大多数患者更喜欢由医生做出决定，尤其是那些病情较重和老年患者。患者通常不会被告知药物相互作用、预防措施和可预见的并发症。全科医生提供的信息似乎不足以促进患者参与临床安全。
