Grant Richard William, Altschuler Andrea, Uratsu Connie Si, Sanchez Gabriela, Schmittdiel Julie Ann, Adams Alyce Sophia, Heisler Michele
Division of Research, Kaiser Permanente Northern California, Oakland, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, USA.
Prim Care Diabetes. 2017 Apr;11(2):148-153. doi: 10.1016/j.pcd.2016.11.003. Epub 2016 Dec 1.
The purpose of this study was to examine how patients with diabetes and their primary care physicians identify and discuss visit priorities prior to and during visits.
We conducted a qualitative study involving patients with diabetes (4 focus groups, n=29) and primary care physicians (6 provider practice meeting discussions, n=67).
Four key themes related to prioritization were identified: 1) the value of identifying visit priorities before the visit; 2) challenges to negotiating priorities during the time-limited visit; 3) the importance of "non-medical" priorities; and 4) the need for strategies to help patients prepare for visits. Both patients and physicians felt that identifying a concise list of key priorities in advance of the visit could help establish collaborative visit agendas and treatment plans.
Identifying and communicating mutually agreed upon priorities for discussion is a key challenge for time-limited primary care visits.
Communication between primary care physicians and their patients with diabetes could be improved by strategies that help patients identify their top visit priorities before the visit.
本研究旨在探讨糖尿病患者及其初级保健医生在就诊前和就诊期间如何确定并讨论就诊优先事项。
我们开展了一项定性研究，涉及糖尿病患者（4个焦点小组，n = 29）和初级保健医生（6次提供者实践会议讨论，n = 67）。
确定了与优先排序相关的四个关键主题：1）就诊前确定就诊优先事项的价值；2）在时间有限的就诊期间协商优先事项的挑战；3）“非医疗”优先事项的重要性；4）需要制定策略帮助患者为就诊做准备。患者和医生都认为，在就诊前确定一份简明的关键优先事项清单有助于制定协作性的就诊议程和治疗计划。
确定并沟通双方商定的讨论优先事项是时间有限的初级保健就诊面临的一项关键挑战。
通过采取策略帮助糖尿病患者在就诊前确定其最重要的就诊优先事项，可以改善初级保健医生与患者之间的沟通。
