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一项关于急性冠状动脉综合征患者信息需求与偏好的纵向研究。

A longitudinal study on the information needs and preferences of patients after an acute coronary syndrome.

作者信息

Greco Andrea, Cappelletti Erika Rosa, Monzani Dario, Pancani Luca, D'Addario Marco, Magrin Maria Elena, Miglioretti Massimo, Sarini Marcello, Scrignaro Marta, Vecchio Luca, Fattirolli Francesco, Steca Patrizia

机构信息

Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy.

Department of Medical and Surgical Critical Care, Cardiac Rehabilitation Unit, University of Florence and Azienda Ospedaliero, Universitaria Careggi, Florence, Italy.

出版信息

BMC Fam Pract. 2016 Sep 20;17:136. doi: 10.1186/s12875-016-0534-8.

Abstract

BACKGROUND

Research has shown that the provision of pertinent health information to patients with cardiovascular disease is associated with better adherence to medical prescriptions, behavioral changes, and enhanced perception of control over the disease. Yet there is no clear knowledge on how to improve information pertinence. Identifying and meeting the information needs of patients and their preferences for sources of information is pivotal to developing patient-led services. This prospective, observational study was aimed at exploring the information needs and perceived relevance of different information sources for patients during the twenty-four months following an acute coronary syndrome.

METHODS

Two hundred and seventeen newly diagnosed patients with acute coronary syndrome were enrolled in the study. The patients were primarily men (83.41 %) with a mean age of 57.28 years (range 35-75; SD = 7.98). Patients' needs for information and the perceived relevance of information sources were evaluated between 2 and 8 weeks after hospitalization (baseline) and during three follow-ups at 6, 12 and 24 months after baseline. Repeated measures ANOVA, Bonferroni post hoc tests and Cochran's Q Test were performed to test differences in variables of interest over time.

RESULTS

Results showed a reduction in information needs, but this decrease was significant only for topics related to daily activities, behavioral habits, risk and complication. At baseline, the primary sources of information were specialists and general practitioners, followed by family members and information leaflets given by physicians. Relevance of other sources changed differently over time.

CONCLUSION

The present longitudinal study is an original contribution to the investigation of changes in information needs and preferences for sources of information among patients who are diagnosed with acute coronary syndrome. One of the main results of this study is that information on self-disease management is perceived as a minor theme for patients even two years after the event. Knowledge on how patients' information needs and perceived relevance of information sources change over time could enhance the quality of chronic disease management, leading health-care systems to move toward more patient-tailored care.

摘要

背景

研究表明,向心血管疾病患者提供相关健康信息与更好地遵守医嘱、行为改变以及增强对疾病的控制感相关。然而,对于如何提高信息的相关性尚无明确认识。识别并满足患者的信息需求及其对信息来源的偏好对于开展以患者为主导的服务至关重要。这项前瞻性观察研究旨在探讨急性冠状动脉综合征患者在发病后的24个月内对不同信息来源的信息需求及感知相关性。

方法

217例新诊断的急性冠状动脉综合征患者纳入本研究。患者以男性为主(83.41%),平均年龄57.28岁(范围35 - 75岁;标准差 = 7.98)。在住院后2至8周(基线)以及基线后6、12和24个月的三次随访期间,评估患者的信息需求以及信息来源的感知相关性。采用重复测量方差分析、Bonferroni事后检验和 Cochr an Q检验来检验感兴趣变量随时间的差异。

结果

结果显示信息需求有所减少,但仅在与日常活动、行为习惯、风险和并发症相关的主题上,这种减少具有统计学意义。在基线时,主要信息来源是专科医生和全科医生,其次是家庭成员以及医生提供的信息手册。其他来源的相关性随时间变化各异。

结论

本纵向研究为调查急性冠状动脉综合征患者的信息需求变化以及对信息来源的偏好做出了原创性贡献。本研究的主要结果之一是,即使在发病两年后,关于自我疾病管理的信息对患者而言仍被视为次要主题。了解患者的信息需求以及信息来源的感知相关性如何随时间变化,可提高慢性病管理质量,促使医疗保健系统朝着更具患者针对性的护理方向发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffd6/5028970/8d59b5c29bc5/12875_2016_534_Fig1_HTML.jpg

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