Chochinov Harvey Max, McClement Susan, Hack Thomas, Thompson Genevieve, Dufault Brenden, Harlos Mike
Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada; College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
J Pain Symptom Manage. 2015 Jun;49(6):974-80.e2. doi: 10.1016/j.jpainsymman.2014.11.291. Epub 2014 Dec 17.
Failure to acknowledge personhood is often the cause of patient and family dissatisfaction. We developed the Patient Dignity Question (PDQ) as a simple means of inquiring about personhood: "What do I need to know about you as a person to give you the best care possible?"
This study aimed to evaluate the impact of the PDQ on patients and families, evaluate its influence on health care providers (HCPs), and determine if HCP characteristics mediate receptivity to PDQ-elicited information.
Palliative care patients or their family members were asked to respond to the PDQ. Responses were summarized, read to participants to ensure accuracy, and with permission, placed in their charts. Patient, family, and HCP responses to the PDQ were then elicited.
A total of 126 participants (66 patients and 60 family members) responded to the PDQ; 99% indicated that the summaries were accurate, 97% permitted the summary to be placed in the chart, 93% felt that the information was important for HCPs to know, and 99% would recommend the PDQ for others. A total of 137 HCPs completed 293 evaluations of individual PDQs; 90% indicated that they learned something new from it, 64% that they were emotionally affected by it, 59% that it influenced their sense of empathy, and 44% that it influenced their care. HCP empathy, job satisfaction, having a meaningful life, and social support mediated responsiveness to PDQ-elicited information.
The PDQ offers an effective way of eliciting personhood, enhancing patient, family, and HCP experience alike.
未能承认患者的人格常常是导致患者及其家属不满的原因。我们开发了患者尊严问题（PDQ）作为一种询问人格的简单方式：“为了尽可能给予您最佳的护理，我需要了解您作为一个人的哪些方面？”
本研究旨在评估PDQ对患者及其家属的影响，评估其对医疗保健提供者（HCP）的影响，并确定HCP的特征是否介导了对PDQ引出信息的接受度。
要求姑息治疗患者或其家属对PDQ做出回应。对回应进行总结，读给参与者以确保准确性，并在获得许可后放入他们的病历中。然后引出患者、家属和HCP对PDQ的回应。
共有126名参与者（66名患者和60名家属）对PDQ做出了回应；99%表示总结准确，97%允许将总结放入病历，93%认为这些信息对HCP了解很重要，99%会向其他人推荐PDQ。共有137名HCP完成了对293个单独PDQ的评估；90%表示他们从中学到了新东西，64%表示他们在情感上受到了影响，59%表示它影响了他们的同理心，44%表示它影响了他们的护理。HCP的同理心、工作满意度、有意义的生活和社会支持介导了对PDQ引出信息的反应。
PDQ提供了一种引出人格的有效方法，同时增强了患者、家属和HCP的体验。
