Jesus Tiago S, Bright Felicity, Kayes Nicola, Cott Cheryl A
Portuguese Ministry of Education. Aggregation of Schools of Escariz, Escariz, Portugal.
Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
BMJ Open. 2016 Jul 19;6(7):e011959. doi: 10.1136/bmjopen-2016-011959.
Person-centredness is a philosophy for organising and delivering healthcare based on patients' needs, preferences and experiences. Although widely endorsed, the concept suffers from a lack of detail and clarification, in turn accounting for ambiguous implementation and outcomes. While a conceptual framework based on a systematic review defines person/patient-centred care components (Scholl et al, 2014), it applies across healthcare contexts and may not be sensitive to the nuances of the rehabilitation of adults with physical impairments. Accordingly, this study aims to build a conceptual framework, based on existing literature, of what person-centredness means in the rehabilitation of adults with physical impairments in the clinical encounter and broader health service delivery.
We will use a scoping review methodology. Searches on relevant databases will be conducted first, combining keywords for 'rehabilitation', 'person-centered' and associated terms (including patient preferences/experiences). Next, snowball searches (citation tracking, references lists) will be performed. Papers will be included if they fall within predefined selection categories (seen as most likely informative on elements pertaining to person-centred rehabilitation) and are written in English, regardless of design (conceptual, qualitative, quantitative). Two reviewers will independently screen titles and abstracts, followed by screening of the full text to determine inclusion. Experts will then be consulted to identify relevant missing papers. This can include elements other than the peer-reviewed literature (eg, book chapters, policy/legal papers). Finally, information that helps to build the concept and practice of person-centred rehabilitation will be abstracted independently by two reviewers and analysed by inductive thematic analysis to build the conceptual framework.
The resulting framework will aid clarification regarding person-centred rehabilitation, which in turn is expected to conceptually ground and inform its operationalisation (eg, measurement, implementation, improvement). Findings will be disseminated through local, national and international stakeholders, both at the clinical and service organisation levels.
以患者为中心是一种基于患者需求、偏好和体验来组织和提供医疗保健服务的理念。尽管这一理念得到广泛认可，但该概念缺乏详细阐释，进而导致实施过程和结果含糊不清。虽然基于系统评价的概念框架界定了以患者为中心的护理要素（朔尔等人，2014年），但其适用于所有医疗保健情境，可能无法敏锐地捕捉到身体有损伤的成年人康复过程中的细微差别。因此，本研究旨在基于现有文献构建一个概念框架，以阐明在临床诊疗及更广泛的医疗服务提供过程中，以患者为中心对于身体有损伤的成年人康复意味着什么。
我们将采用范围综述方法。首先在相关数据库中进行检索，结合 “康复”、“以患者为中心” 及相关术语（包括患者偏好/体验）的关键词。接下来进行滚雪球式检索（引文追踪、参考文献列表）。如果论文属于预定义的选择类别（被视为最有可能提供与以患者为中心的康复相关要素的信息）且为英文撰写，无论其设计类型（概念性、定性、定量），均将被纳入。两名评审人员将独立筛选标题和摘要，随后进行全文筛选以确定是否纳入。然后将咨询专家以识别相关的遗漏论文。这可能包括同行评审文献之外的要素（如书籍章节、政策/法律文件）。最后将由两名评审人员独立提取有助于构建以患者为中心的康复概念和实践的信息，并通过归纳主题分析进行分析，以构建概念框架。
最终形成的框架将有助于阐明以患者为中心的康复，进而有望在概念上为其实施（如测量、实施、改进）奠定基础并提供指导。研究结果将通过临床和服务组织层面的地方、国家和国际利益相关者进行传播。
