Frost Jane, Currie Marian J, Cruickshank Mary
University of Canberra, Canberra, Australia
University of Canberra, Canberra, Australia Australian National University, Canberra, Australia.
J Prim Care Community Health. 2015 Oct;6(4):264-78. doi: 10.1177/2150131915598373. Epub 2015 Jul 30.
To review how enablement is conceptualized and practiced in primary health care and to explore the factors that influence patient enablement in this setting.
A narrative integrative literature review was undertaken.
Twenty-four articles specifically relating to enablement in primary health care were identified. Three literature reviews, 4 qualitative studies, and 17 quantitative studies were included in the analysis.
In the primary health care setting, the concept of enablement is well defined as an outcome measure of quality. The literature exploring the practice of enablement is sparse, but 2 randomized controlled trials suggest enablement is linked to better outcomes for patients with asthma and diabetes. Primary factors influencing enablement included the practitioners' open communication style, the degree to which the practitioner is patient centered, and longer consultations. Other factors found to be associated with enablement were the presenting health issue, general state of health, ethnicity, the patient's own coping strategies and degree of independence, and socioeconomic status. The association between enablement and patients' expectations and satisfaction is less clear. The majority of research on enablement was carried out among general practitioners. Further research into the degree to which patients are enabled by a wider range of health care providers is needed. Additional qualitative research would provide a deeper understanding of the attributes of enablement in the primary health care setting.
回顾在初级卫生保健中赋能是如何被概念化和实践的，并探讨在这种环境下影响患者赋能的因素。
进行了一项叙述性综合文献综述。
确定了24篇专门涉及初级卫生保健中赋能的文章。分析纳入了3篇文献综述、4篇定性研究和17篇定量研究。
在初级卫生保健环境中，赋能的概念被明确界定为质量的一项结果指标。探索赋能实践的文献较少，但2项随机对照试验表明，赋能与哮喘和糖尿病患者的更好结局相关。影响赋能的主要因素包括从业者开放的沟通方式、以患者为中心的程度以及更长的咨询时间。其他与赋能相关的因素包括所呈现的健康问题、总体健康状况、种族、患者自身的应对策略和独立程度以及社会经济地位。赋能与患者期望和满意度之间的关联不太明确。关于赋能的大多数研究是在全科医生中进行的。需要进一步研究更广泛的医疗保健提供者使患者获得赋能的程度。更多的定性研究将有助于更深入地了解初级卫生保健环境中赋能的属性。
