Roy Natalie T, Ulrich Erin E
Department of Pharmaceutical, Biomedical, and Administrative Sciences, College of Pharmacy and Health Sciences, Drake University, Des Moines, IA, USA.
Drug Healthc Patient Saf. 2017 Jan 16;9:1-8. doi: 10.2147/DHPS.S107065. eCollection 2017.
Improving the patient-physician relationship through patient involvement in the care may lead to improved patient safety and better health outcomes. There exists a gap in knowledge in identifying factors that affect self-reported patient involvement in individualized treatment plans. The objectives of this study were to 1) describe patients' perceptions of their involvement in the creation and implementation of their treatment plans and 2) determine if patient involvement varied by medical condition or demographic characteristics.
This study was a cross-sectional analysis of data from the "Quality of Care" module of the 2008 Health and Retirement Study (HRS). The individuals of HRS surveys were older than 50 years. One-way analyses of variance were conducted to determine differences between patient characteristics and involvement in creating a treatment plan. A linear regression was conducted to determine predictors of the summed involvement score.
Average summed scores for each domain (shared decision-making, counseling, and follow-up) and overall involvement scores were ~50%. Linear regression showed that being non-White, older age, and diagnosed with a psychiatric condition or diabetes were predictors of increased self-reported involvement in the development and communication of a patient's treatment plan.
Age, race, and having diabetes or a psychiatric condition were the major predictors affecting patient involvement in care, although overall involvement in care was low for all groups.
Patient involvement in care was lower than expected and should be further studied to determine the effects of involvement on health outcomes.
通过让患者参与护理来改善医患关系，可能会提高患者安全性并带来更好的健康结果。在识别影响患者自我报告参与个性化治疗计划的因素方面，存在知识差距。本研究的目的是：1）描述患者对其参与制定和实施治疗计划的看法；2）确定患者参与度是否因医疗状况或人口统计学特征而异。
本研究是对2008年健康与退休研究（HRS）“护理质量”模块数据的横断面分析。HRS调查的个体年龄超过50岁。进行单因素方差分析以确定患者特征与参与制定治疗计划之间的差异。进行线性回归以确定总参与得分的预测因素。
每个领域（共同决策、咨询和随访）的平均总得分以及总体参与得分约为50%。线性回归表明，非白人、年龄较大以及被诊断患有精神疾病或糖尿病是患者自我报告参与治疗计划制定和沟通增加的预测因素。
年龄、种族以及患有糖尿病或精神疾病是影响患者参与护理的主要预测因素，尽管所有组的总体护理参与度都较低。
患者参与护理的程度低于预期，应进一步研究以确定参与对健康结果的影响。
