Mills I, Frost J, Kay E, Moles D R
NIHR Academic Fellow in General Dental Medicine and Honorary Lecturer.
University of Exeter Medical School.
Br Dent J. 2015 Apr 10;218(7):407-12; discussion 413. doi: 10.1038/sj.bdj.2015.248.
To develop an understanding of the key features of person-centred care (PCC) in relation to general dental practice from a patient's perspective.
PCC is acknowledged as an important dimension of quality with 'patient experience' increasingly used as a marker of quality within the NHS. A Dental Quality and Outcomes Framework (DQOF) is currently being piloted in the UK, which includes patient experience as one of the three domains. It is recognised that there is limited understanding of PCC within dentistry, with little evidence published on the subject.
This study uses qualitative methods to explore the views of 16 purposively sampled patients living in Southwest England. In-depth semi-structured interviews were recorded, transcribed, coded and analysed thematically.
PCC was viewed as key in the delivery of high-quality care. Dimensions of PCC were identified and categorised as relational or functional aspects of care. Relational aspects of care were viewed as being central to the delivery of PCC with five components identified and named: connection, attitude, communication, empowerment and feeling valued. Functional aspects of care were identified as healthcare system and physical environment and were noted to influence PCC to a variable degree.
A model of PCC in dentistry is proposed which has been generated from empirical evidence that represents the views of patients. It is hoped that this may inform and influence development of a tool to measure PCC within any future version of the DQOF.
从患者角度深入了解以患者为中心的护理(PCC)在普通牙科实践中的关键特征。
PCC被认为是质量的一个重要维度,“患者体验”在英国国家医疗服务体系(NHS)中越来越多地被用作质量指标。目前英国正在试行牙科质量与结果框架(DQOF),其中患者体验是三个领域之一。人们认识到,牙科领域对PCC的理解有限,关于这一主题发表的证据很少。
本研究采用定性方法,对居住在英格兰西南部的16名有目的抽样的患者的观点进行探索。对深入的半结构化访谈进行录音、转录、编码并进行主题分析。
PCC被视为提供高质量护理的关键。确定了PCC的维度,并将其归类为护理的关系性或功能性方面。护理的关系性方面被视为PCC实施的核心,确定并命名了五个组成部分:联系、态度、沟通、赋权和感到被重视。护理的功能性方面被确定为医疗保健系统和物理环境,并指出它们在不同程度上影响PCC。
提出了一个牙科PCC模型,该模型基于代表患者观点的实证证据。希望这能为未来DQOF版本中衡量PCC的工具的开发提供信息并产生影响。