Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.
University of Washington, Seattle, WA, USA.
J Gen Intern Med. 2017 Dec;32(12):1278-1284. doi: 10.1007/s11606-017-4154-3. Epub 2017 Aug 28.
To improve care for individuals living with multiple chronic conditions, patients and providers must align care planning with what is most important to patients in their daily lives. We have a limited understanding of how to effectively encourage communication about patients' personal values during clinical care.
To identify what patients with multiple chronic conditions describe as most important to their well-being and health.
We interviewed individuals with multiple chronic conditions in their homes and analyzed results qualitatively, guided by grounded theory.
A total of 31 patients (mean age 68.7 years) participated in the study, 19 of which included the participation of family members. Participants were from Kaiser Permanente Washington, an integrated health care system in Washington state.
Qualitative analysis of home visits, which consisted of semi-structured interviews aided by photo elicitation.
Analysis revealed six domains of what patients described as most important for their well-being and health: principles, relationships, emotions, activities, abilities, and possessions. Personal values were interrelated and rarely expressed as individual values in isolation.
The domains describe the range and types of personal values multimorbid older adults deem important to well-being and health. Understanding patients' personal values across these domains may be useful for providers when developing, sharing, and following up on care plans.
为了改善患有多种慢性疾病的个体的护理，患者和提供者必须将护理计划与患者日常生活中最重要的内容保持一致。我们对于如何有效地鼓励在临床护理中讨论患者的个人价值观知之甚少。
确定患有多种慢性疾病的个体认为对其福祉和健康最重要的内容。
我们在患者家中对其进行访谈，并根据扎根理论进行定性分析。
共有 31 名患有多种慢性疾病的患者（平均年龄 68.7 岁）参与了这项研究，其中 19 名患者的家属也参与了研究。参与者来自华盛顿州的 Kaiser Permanente Washington，这是一个综合性的医疗保健系统。
对家访进行定性分析，家访由半结构化访谈和照片启发法辅助进行。
分析揭示了患者描述的对其福祉和健康最重要的六个领域：原则、人际关系、情绪、活动、能力和财产。个人价值观是相互关联的，很少单独作为个人价值观表达。
这些领域描述了患有多种慢性疾病的老年患者认为对福祉和健康重要的个人价值观的范围和类型。了解患者在这些领域的个人价值观，对于提供者在制定、分享和跟踪护理计划时可能会有所帮助。
