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为患者价值观在临床对话中得以呈现创造条件:医疗团队成员的观点

Creating Conditions for Patients' Values to Emerge in Clinical Conversations: Perspectives of Health Care Team Members.

作者信息

Berry Andrew B L, Lim Catherine, Hartzler Andrea L, Hirsch Tad, Ludman Evette, Wagner Edward H, Ralston James D

机构信息

University of Washington, Seattle, WA USA.

Kaiser Permanente Washington Health, Research Institute, Seattle, WA USA.

出版信息

DIS (Des Interact Syst Conf). 2017 Jun;2017:1165-1174. doi: 10.1145/3064663.3064669.

Abstract

Eliciting, understanding, and honoring patients' values- the things most important to them in daily life-is a cornerstone of patient-centered care. However, this rarely occurs explicitly as a routine part of clinical practice. This is particularly problematic for individuals with multiple chronic conditions (MCC) because they face difficult choices about how to balance competing demands for self-care in accordance with their values. In this study, we sought to inform the design of interventions to support conversations about patient values between patients with MCC and their health care providers. We conducted a field study that included observations of 21 clinic visits for patients who have MCC, and interviews with 16 care team members involved in those visits. This paper contributes a practice-based account of ways in which providers engage with patient values, and discusses how future work in interactive systems design might extend and enrich these engagements.

摘要

引出、理解并尊重患者的价值观——即他们日常生活中最重要的事情——是以患者为中心的医疗护理的基石。然而,这很少作为临床实践的常规部分明确发生。这对患有多种慢性病(MCC)的个体来说尤其成问题,因为他们面临着如何根据自身价值观平衡自我护理的相互冲突需求的艰难选择。在本研究中,我们旨在为支持MCC患者与其医疗服务提供者之间关于患者价值观的对话的干预措施设计提供信息。我们进行了一项实地研究,其中包括对21名患有MCC的患者的门诊进行观察,以及对参与这些门诊的16名护理团队成员进行访谈。本文基于实践阐述了医疗服务提供者与患者价值观互动的方式,并讨论了交互式系统设计未来的工作如何可能扩展和丰富这些互动。

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