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全科医生单次诊疗后的患者赋能:对芬兰QUALICOPC数据的分析

Patient Enablement After a Single Appointment With a GP: Analysis of Finnish QUALICOPC Data.

作者信息

Tolvanen Elina, Koskela Tuomas H, Helminen Mika, Kosunen Elise

机构信息

1 University of Tampere, Tampere, Finland.

2 Pirkkala Municipal Health Centre, Pirkkala, Finland.

出版信息

J Prim Care Community Health. 2017 Oct;8(4):213-220. doi: 10.1177/2150131917730211. Epub 2017 Sep 15.

Abstract

BACKGROUND

Patient enablement is described as patient's ability to understand and cope with illness after a consultation. The purpose of this study was to analyze factors associated with enablement in Finnish primary health care. An additional aim was to evaluate whether a single question could be used to measure enablement.

METHODS

A questionnaire survey was addressed to Finnish general practitioners (GPs) within the Quality and Costs of Primary Care in Europe (QUALICOPC) study framework. A trained fieldworker contacted nine patients for every participating GP. Two to 9 patients per GP (median 9 patients) completed the questionnaire. Patient enablement was measured by a single question based on the Patient Enablement Instrument questionnaire. Multivariate and multilevel analyses were performed to find variables that have an independent association with patient enablement.

RESULTS

A total of 1196 patients completed the QUALICOPC questionnaire. A total of 898 patients (75.1%) agreed that they felt better able to cope with their health problem or illness after an appointment with a GP, reflecting patient enablement. In the theme group analyses, 11 factors were found to have a statistically significant ( P < .05) association with enablement. In the final multivariable model, positive perceptions of doctor-patient communication and patient satisfaction were positively associated with enablement.

CONCLUSIONS

The results, using a single question to measure enablement, are comparable to previous findings on factors associated with enablement. Further research is needed and these results should be regarded as preliminary.

摘要

背景

患者赋能被描述为患者在咨询后理解和应对疾病的能力。本研究的目的是分析芬兰初级卫生保健中与赋能相关的因素。另一个目的是评估是否可以用一个问题来衡量赋能。

方法

在欧洲初级保健质量与成本(QUALICOPC)研究框架内向芬兰全科医生(GP)进行问卷调查。一名经过培训的现场工作人员为每位参与的全科医生联系九名患者。每位全科医生有2至9名患者(中位数为9名患者)完成问卷。基于患者赋能工具问卷,通过一个问题来衡量患者赋能。进行多变量和多层次分析以找出与患者赋能有独立关联的变量。

结果

共有1196名患者完成了QUALICOPC问卷。共有898名患者(75.1%)表示,在与全科医生预约后,他们感觉更有能力应对自己的健康问题或疾病,这反映了患者赋能。在主题组分析中,发现11个因素与赋能有统计学显著关联(P <.05)。在最终的多变量模型中,对医患沟通的积极看法和患者满意度与赋能呈正相关。

结论

使用一个问题来衡量赋能的结果与先前关于赋能相关因素的研究结果具有可比性。需要进一步研究,这些结果应被视为初步结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9be8/5932738/453ef31c4e5d/10.1177_2150131917730211-fig1.jpg

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