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系统性硬化症与基层医疗中的质量认知

Systemic Sclerosis and Perceptions of Quality in Primary Care.

作者信息

Toci Ashley L, Hyer J Madison, Silver Richard M, Nietert Paul J, Hant Faye N

机构信息

Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.

Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.

出版信息

Am J Med Sci. 2016 May;351(5):447-51. doi: 10.1016/j.amjms.2016.02.021. Epub 2016 Feb 17.

Abstract

BACKGROUND

Among patients with systemic sclerosis (SSc), early recognition of potentially life-threatening organ involvement is critical. Because prompt recognition of early signs of organ involvement can dramatically alter a patient׳s outcome, it is crucial that patients and primary care providers (PCPs) recognize these symptoms. We conducted a survey of patients with SSc regarding their perceptions of the quality of their primary care, and whether or not they perceive the quality of their primary care to be impaired by their scleroderma diagnosis.

MATERIALS AND METHODS

A mail survey was sent to 525 patients with SSc seen at the Medical University of South Carolina. Questionnaire items addressed demographics and perceptions of their quality of their primary care.

RESULTS

Of n = 140 respondents, most (74.5%) did not feel as though their diagnosis of SSc has resulted in barriers to appropriate or satisfactory care, and most (81.3%) answered that they had not ever felt as though their medical concerns were not being addressed because they had SSc. Perceptions of barriers were significantly (P < 0.05) associated with female sex and younger age, along with poorer overall quality of care and satisfaction with their primary care.

CONCLUSIONS

Most patients with SSc value the quality of their primary care. However, some patients with SSc feel that their PCPs do not adequately monitor their blood pressure, reflux symptoms or shortness of breath. These results highlight the importance of PCPs in the overall care of patients with SSc and the need for continued education regarding close monitoring of signs and symptoms suggestive of possible life-threatening internal organ involvement.

摘要

背景

在系统性硬化症(SSc)患者中,早期识别可能危及生命的器官受累情况至关重要。由于及时识别器官受累的早期迹象可显著改变患者的预后,因此患者和初级保健提供者(PCP)识别这些症状至关重要。我们对SSc患者进行了一项关于他们对初级保健质量的看法以及他们是否认为硬皮病诊断会损害其初级保健质量的调查。

材料与方法

向南卡罗来纳医科大学就诊的525例SSc患者发送了邮件调查问卷。问卷项目涉及人口统计学和对其初级保健质量的看法。

结果

在n = 140名受访者中,大多数(74.5%)并不觉得他们的SSc诊断导致了获得适当或满意治疗的障碍,并且大多数(81.3%)回答说他们从未觉得因为患有SSc而自己的医疗问题未得到解决。对障碍的看法与女性性别、较年轻的年龄以及总体护理质量较差和对其初级保健的满意度显著相关(P < 0.05)。

结论

大多数SSc患者重视他们的初级保健质量。然而,一些SSc患者觉得他们的初级保健提供者没有充分监测他们的血压、反流症状或呼吸急促情况。这些结果凸显了初级保健提供者在SSc患者整体护理中的重要性以及对持续教育的需求,内容涉及密切监测提示可能危及生命的内部器官受累的体征和症状。

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