Beckwith Noor, Jean-Baptiste Marie-Louise, Katz Arlene
Harvard Medical School, Boston, MA, USA.
Department of Medicine, Cambridge Health Alliance, Cambridge, MA, USA.
J Community Health. 2016 Dec;41(6):1196-1203. doi: 10.1007/s10900-016-0201-y.
The increasing burden of chronic diseases in the United States presents a major challenge to the nation's primary care systems, so improving the efficacy and efficiency of patient education is an important goal. Understanding the current perspectives, practices, and needs of primary care providers should guide innovation towards this end. As a part of the authors' ongoing quality improvement work, a short internet survey was an effective method of enhancing this understanding in one health care system. With a response rate of 24.6 %, the survey revealed that primary care waiting rooms in the health system studied are not conceived of or used by providers as spaces to engage patients in health education. To change this, providers suggested using both printed and technological methods for delivering health information, primarily related to medications, diabetes, and healthy lifestyle practices. Common barriers to improvement cited by providers included diverse language and literacy backgrounds in the patient population, as well as difficulty sustaining change due to infrastructural and administrative barriers. These results suggest steps for development, implementation, and investigation of new educational interventions for patients in the local primary care context.
美国慢性病负担日益加重,这给该国的初级保健系统带来了重大挑战,因此提高患者教育的效果和效率是一个重要目标。了解初级保健提供者当前的观点、做法和需求应能指导为此目的进行的创新。作为作者正在进行的质量改进工作的一部分,一项简短的网络调查是增强对一个医疗系统这方面理解的有效方法。调查回复率为24.6%,结果显示,在所研究的医疗系统中,初级保健候诊室并未被提供者视为或用作让患者参与健康教育的场所。为改变这种情况,提供者建议使用印刷和技术方法来提供健康信息,主要涉及药物、糖尿病和健康生活方式。提供者提到的改进的常见障碍包括患者群体语言和文化程度背景各异,以及由于基础设施和行政障碍难以维持变革。这些结果为在当地初级保健环境中开发、实施和研究针对患者的新教育干预措施提出了步骤。