Synnot Anneliese, Bragge Peter, Lowe Dianne, Nunn Jack S, O'Sullivan Molly, Horvat Lidia, Tong Allison, Kay Debra, Ghersi Davina, McDonald Steve, Poole Naomi, Bourke Noni, Lannin Natasha, Vadasz Danny, Oliver Sandy, Carey Karen, Hill Sophie J
Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
BMJ Open. 2018 May 8;8(5):e019481. doi: 10.1136/bmjopen-2017-019481.
To identify research priorities of consumers and other stakeholders to inform Cochrane Reviews in 'health communication and participation' (including such concepts as patient experience, shared decision-making and health literacy).
International.
We included anyone with an interest in health communication and participation. Up to 151 participants (18-80 years; 117 female) across 12 countries took part, including 48 consumers (patients, carers, consumer representatives) and 75 professionals (health professionals, policymakers, researchers) (plus 25 people who identified as both).
Survey.
We invited people to submit their research ideas via an online survey open for 4 weeks. Using inductive thematic analysis, we generated priority research topics, then classified these into broader themes.
Participants submitted 200 research ideas, which we grouped into 21 priority topics. Key research priorities included: insufficient consumer involvement in research (19 responses), 'official' health information is contradictory and hard to understand (18 responses), communication/coordination breakdowns in health services (15 responses), health information provision a low priority for health professionals (15 responses), insufficient eliciting of patient preferences (14 responses), health services poorly understand/implement patient-centred care (14 responses), lack of holistic care impacting healthcare quality and safety (13 responses) and inadequate consumer involvement in service design (11 responses). These priorities encompassed acute and community health settings, with implications for policy and research. Priority populations of interest included people from diverse cultural and linguistic backgrounds, carers, and people with low educational attainment, or mental illness. Most frequently suggested interventions focused on training and cultural change activities for health services and health professionals.
Consumers and other stakeholders want research addressing structural and cultural challenges in health services (eg, lack of holistic, patient-centred, culturally safe care) and building health professionals' communication skills. Solutions should be devised in partnership with consumers, and focus on the needs of vulnerable groups.
确定消费者和其他利益相关者的研究重点,以为循证医学评价提供有关“健康沟通与参与”(包括患者体验、共同决策和健康素养等概念)的信息。
国际范围。
我们纳入了任何对健康沟通与参与感兴趣的人。来自12个国家的多达151名参与者(年龄在18至80岁之间;117名女性)参与其中,包括48名消费者(患者、护理人员、消费者代表)和75名专业人员(卫生专业人员、政策制定者、研究人员)(另外还有25人同时属于这两类)。
调查。
我们邀请人们通过一项为期4周的在线调查提交他们的研究想法。通过归纳主题分析,我们生成了优先研究主题,然后将这些主题归类为更宽泛的主题。
参与者提交了200个研究想法,我们将其归为21个优先主题。主要研究重点包括:消费者在研究中的参与不足(19份反馈)、“官方”健康信息相互矛盾且难以理解(18份反馈)、卫生服务中的沟通/协调故障(15份反馈)、健康信息提供在卫生专业人员工作中未被列为优先事项(15份反馈)、对患者偏好的询问不足(14份反馈)、卫生服务对以患者为中心的护理理解/实施不足(14份反馈)、缺乏整体护理影响医疗质量和安全(13份反馈)以及消费者在服务设计中的参与不足(11份反馈)。这些重点涵盖了急性和社区卫生环境,对政策和研究均有影响。感兴趣的优先人群包括来自不同文化和语言背景的人、护理人员以及教育程度低或患有精神疾病的人。最常被建议的干预措施集中在针对卫生服务机构和卫生专业人员的培训及文化变革活动上。
消费者和其他利益相关者希望开展研究,以应对卫生服务中的结构和文化挑战(例如缺乏整体的、以患者为中心的、文化上安全的护理)并提升卫生专业人员的沟通技能。应与消费者合作制定解决方案,并关注弱势群体的需求。