Berry Andrew B L, Lim Catherine, Hartzler Andrea L, Hirsch Tad, Ludman Evette, Wagner Edward H, Ralston James D
University of Washington, Seattle, WA, USA.
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
AMIA Annu Symp Proc. 2018 Apr 16;2017:430-439. eCollection 2017.
Patients with multiple chronic conditions often face competing demands for care, and they often do not agree with physicians on priorities for care. Patients ' values shape their healthcare priorities, but existing methods for eliciting values do not necessarily meet patients ' care planning needs. We developed a patient-centered values framework based on a field study with patients and caregivers. In this paper we report on a survey to evaluate how the framework generalizes beyond field study participants, and how well the framework supports values elicitation. We found that respondents frame values in a way that is consistent with the framework, and that domains of the framework can be used to elicit a breadth of potential values individuals with MCC express. These findings demonstrate how a patient-centered perspective on values can expand on the domains considered in values clarification methods andfacilitate patient-provider communication in establishing shared care priorities.
患有多种慢性病的患者常常面临相互冲突的护理需求,而且他们在护理重点方面往往与医生意见不一。患者的价值观塑造了他们的医疗保健重点,但现有的获取价值观的方法不一定能满足患者的护理计划需求。我们基于对患者及其护理人员的实地研究,开发了一个以患者为中心的价值观框架。在本文中,我们报告了一项调查,以评估该框架如何在实地研究参与者之外进行推广,以及该框架在支持价值观获取方面的效果如何。我们发现,受访者以与该框架一致的方式阐述价值观,并且该框架的各个领域可用于引出患有多种慢性病的个体所表达的广泛潜在价值观。这些发现表明,以患者为中心的价值观视角如何能够扩展价值观澄清方法中所考虑的领域,并在确立共同的护理重点方面促进患者与提供者之间的沟通。