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社会工作、护理和医学中以患者为中心的意义和认知:一项比较研究。

Meanings and perceptions of patient-centeredness in social work, nursing and medicine: a comparative study.

机构信息

Department of Internal Medicine, University Hospital of Lausanne, Lausanne 1011, Switzerland.

出版信息

J Interprof Care. 2012 Nov;26(6):484-90. doi: 10.3109/13561820.2012.717553. Epub 2012 Aug 28.

Abstract

Answering patients' evolving, more complex needs has been recognized as a main incentive for the development of interprofessional care. Thus, it is not surprising that patient-centered practice (PCP) has been adopted as a major outcome for interprofessional education. Nevertheless, little research has focused on how PCP is perceived across the professions. This study aimed to address this issue by adopting a phenomenological approach and interviewing three groups of professionals: social workers (n = 10), nurses (n = 10) and physicians (n = 8). All the participants worked in the same department (the General Internal Medicine department of a university affiliated hospital). Although the participants agreed on a core meaning of PCP as identifying, understanding and answering patients' needs, they used many dimensions to define PCP. Overall, the participants expressed value for PCP as a philosophy of care, but there was the sense of a hierarchy of patient-centeredness across the professions, in which both social work and nursing regarded themselves as more patient-centered than others. On their side, physicians seemed inclined to accept their lower position in this hierarchy. Gieryn's concept of boundary work is employed to help illuminate the nature of PCP within an interprofessional context.

摘要

满足患者不断变化的、更复杂的需求已被认为是开展跨专业护理的主要动力。因此,以患者为中心的实践(PCP)被作为跨专业教育的主要成果也就不足为奇了。然而,很少有研究关注到不同专业对 PCP 的看法。本研究采用现象学方法,对三组专业人员进行了访谈,旨在解决这一问题,这三组专业人员分别是:社会工作者(n=10)、护士(n=10)和医生(n=8)。所有参与者都在同一部门工作(大学附属医院的普通内科)。尽管参与者对 PCP 的核心含义达成了一致,即确定、理解和满足患者的需求,但他们使用了许多维度来定义 PCP。总的来说,参与者对 PCP 作为一种关怀哲学表示赞赏,但在专业之间存在着一种以患者为中心的等级制度的感觉,在这种等级制度中,社会工作和护理都认为自己比其他专业更以患者为中心。另一方面,医生似乎倾向于接受他们在这个等级制度中的较低地位。吉仁的边界工作概念被用来帮助阐明跨专业背景下 PCP 的本质。

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