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通过 PRACTA 干预激活老年患者:方法重要吗?

Activation of older patients through PRACTA intervention for primary healthcare doctors: does the method matter?

机构信息

Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.

Department of Public Health and Nursing, NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Eur J Public Health. 2017 Dec 1;27(6):998-1003. doi: 10.1093/eurpub/ckx129.

Abstract

BACKGROUND

Activating older adults in medical practice can benefit patients' health and quality of life, as well as the economy and burden of the healthcare system. Placing general practice in the public healthcare system gives the elderly population easy access to the promotion of active attitudes toward health, provided that the doctors have and use relevant activating tools. The aim of this study was to verify the possibility of activating senior patients through an educational intervention for doctors.

METHODS

Two waves of data collection from primary care patients and their doctors were separated by an intervention for doctors. The intervention took the form of an e-learning programme or article and was developed so as to improve general practitioners' (GP) communication and activation skills, especially when working with older adults. The outcome variable was the change between the waves in patients' scores on the PRACTA Attitude Toward Treatment and Health (ATH) Scale and PRACTA Self-efficacy Scale. Data from patients aged 50 + (n = 2175; 55.6% women; age: M = 69.56, SD = 9.10) appointed at the primary care facilities were analysed.

RESULTS

The analysis revealed the effect of doctors' e-learning and, to a lesser extent, the effect of article reading on patients' attitudes toward treatment and health as well as on their self-efficacy. In facilities in which the intervention was implemented, patients' attitudes were more active on follow-up than at baseline when compared with facilities without the intervention.

CONCLUSIONS

Educational intervention among doctors can result in patients' ATH becoming more active. The form of intervention might diversify the impact.

摘要

背景

在医疗实践中激发老年人的积极性可以使患者的健康和生活质量受益,也可以使经济和医疗保健系统的负担受益。将一般实践置于公共医疗保健系统中,可以使老年人口更容易获得促进积极健康态度的机会,只要医生拥有并使用相关的激活工具即可。本研究的目的是验证通过对医生进行教育干预来激发老年患者的可能性。

方法

将来自初级保健患者及其医生的两轮数据收集通过针对医生的干预措施分开。干预措施采用电子学习计划或文章的形式,旨在提高全科医生的沟通和激活技能,尤其是在与老年人合作时。因变量是患者在 PRACTA 对治疗和健康的态度量表(ATH)和 PRACTA 自我效能量表上的分数在两个波之间的变化。对在初级保健机构预约的年龄在 50 岁及以上的患者(n = 2175;55.6%女性;年龄:M = 69.56,SD = 9.10)的数据进行了分析。

结果

分析显示,医生的电子学习以及在较小程度上阅读文章对患者的治疗态度和健康态度以及自我效能均有影响。在实施干预的机构中,与未实施干预的机构相比,患者在随访时的态度比基线时更积极。

结论

医生的教育干预可以使患者的 ATH 变得更加活跃。干预形式可能会使影响多样化。

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