Department of Psychology, Université du Québec à Montréal, PO Box 8888, Station Centre-ville, Montreal, QC H3C 3P8.
Can Fam Physician. 2012 Dec;58(12):1366-73.
To evaluate chronic illness care delivery from the patient's perspective and to examine its main correlates.
Cross-sectional, descriptive study using questionnaires and medical chart review.
Nine teaching family practices in Quebec.
A total of 364 patients with diabetes, hypertension, or chronic obstructive pulmonary disease.
Score on the Patient Assessment of Chronic Illness Care (PACIC) questionnaire, which evaluates the patient's perspective on the care received based on the chronic care model (CCM); patients characteristics (sex, level of education, number of chronic illnesses); patient-physician relationship (relational continuity, interpersonal communication assessed from the patient's perspective); and interdisciplinary care and technical quality of care abstracted from patients' medical charts.
The mean PACIC score obtained (2.8 out of 5) indicates that, on average, CCM-concordant care "generally did not occur" or occurred only "sometimes" in this network of teaching practices. However, with a mean technical quality-of-care score of nearly 80%, physicians in this network showed a high degree of adherence to clinical guidelines for the chronic illnesses under study. Patient education level lower than high school was negatively associated with PACIC scores, while positive associations were found with male sex, number of chronic illnesses, relational continuity, interpersonal communication, interdisciplinary care, and technical quality of care.
Patients with less education reported receiving less CCM-concordant care. The patient-physician relationship was the strongest correlate of PACIC scores, while interdisciplinary care and technical quality of care had modest contributions.
从患者角度评估慢性病护理的提供情况，并考察其主要相关因素。
使用问卷和病历回顾进行的横断面描述性研究。
魁北克的 9 个教学家庭实践。
共 364 名患有糖尿病、高血压或慢性阻塞性肺疾病的患者。
慢性病患者评估护理的患者评估（PACIC）问卷评分，该评分根据慢性病护理模型（CCM）评估患者对所接受护理的看法；患者特征（性别、教育程度、慢性病数量）；医患关系（关系连续性，从患者角度评估的人际沟通）；以及从患者病历中提取的跨学科护理和技术护理质量。
获得的平均 PACIC 评分（5 分制中的 2.8 分）表明，在这个教学实践网络中，CCM 一致的护理“通常没有发生”或仅“有时发生”。然而，该网络的医生的技术护理质量平均得分接近 80%，表明他们高度遵守了所研究慢性病的临床指南。患者教育程度低于高中与 PACIC 评分呈负相关，而与男性、慢性病数量、关系连续性、人际沟通、跨学科护理和技术护理质量呈正相关。
教育程度较低的患者报告接受的 CCM 一致护理较少。医患关系是 PACIC 评分的最强相关因素，而跨学科护理和技术护理质量有适度的贡献。
