Orthopaedic Assessment Service, Somerset Partnership NHS Foundation Trust, 48 Parkfield Drive, Taunton, Somerset TA1 5BU, UK.
Faculty of Health & Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Bristol BS16 1DD, UK.
Musculoskelet Sci Pract. 2018 Jun;35:84-89. doi: 10.1016/j.msksp.2018.03.005. Epub 2018 Mar 10.
Person-centred approaches to care require clinicians to engage in trying to understand the full range of problems and concerns, treatment and investigation requests, and emotional and social issues that people bring to the consultation. If, however, the main issues of importance are not openly declared and discussed they cannot be addressed. This is likely to result in people receiving the care that clinicians think they need, rather than care based on individual needs and preferences.
To understand people's abilities to express the issues of importance to them within a consultation and clinicians' abilities to acknowledge and address those issues.
A qualitative study using an interpretive phenomenological approach.
Fifteen people and their physiotherapists were interviewed and their consultations recorded. The resulting data sets were analysed to identify and report themes within the data.
The findings revealed that people present with what are often simple issues, but which are sometimes expressed in an unstructured way in clinical encounters and are often difficult for clinicians to establish. Three linked themes emerged: (1) clear versus unstructured agendas; (2) people need information and understanding; and (3) developing a sense of collaboration.
The issues of importance that people bring to a consultation are varied and often vague. This research highlights the importance of communication to elicit, identify and address the issues of importance to people in clinical encounters to ensure a positive experience and outcome for both the individual person and clinician.
Achieving desirable health outcomes is more likely when people are supported to think about their priorities and 'what matters to them'.
以患者为中心的护理方法要求临床医生努力理解患者在就诊时提出的各种问题和关注点、治疗和检查请求以及情感和社会问题。然而，如果重要的主要问题没有公开声明和讨论，那么这些问题就无法得到解决。这可能导致患者接受的是临床医生认为他们需要的护理，而不是基于个人需求和偏好的护理。
了解患者在就诊时表达自身重要问题的能力，以及临床医生承认和解决这些问题的能力。
采用解释性现象学方法的定性研究。
对 15 名患者及其物理治疗师进行了访谈，并记录了他们的就诊过程。对所得数据集进行了分析，以确定和报告数据中的主题。
研究结果表明，患者就诊时通常呈现出简单的问题，但这些问题在临床就诊中有时以非结构化的方式表达，而且临床医生往往难以确定这些问题。出现了三个相关主题：（1）明确与非结构化议程；（2）患者需要信息和理解；（3）建立合作意识。
患者就诊时提出的重要问题多种多样，且往往比较模糊。本研究强调了沟通的重要性，以引出、识别和解决患者在临床就诊中重要的问题，从而确保个人和临床医生都能获得积极的就诊体验和结果。
当患者能够思考自己的优先事项和“对他们重要的事情”时，他们更有可能获得理想的健康结果。
