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支持团队、技术和患者参与与支持以患者为中心的护理相关的决策。

Support for teams, technology and patient involvement in decision-making associated with support for patient-centred care.

机构信息

Department of Medicine Division of Experimental Medicine, McGill University, Montreal, QC H4A 3J1, Canada.

Department of Clinical Epidemiology, Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada.

出版信息

Int J Qual Health Care. 2019 Oct 31;31(8):590-597. doi: 10.1093/intqhc/mzy224.

Abstract

OBJECTIVE

Patient-centred care is recommended to transform healthcare delivery to improve the quality and safety of healthcare. This study aimed to assess the determinants of support for attributes of patient-centred care (PCC) from Canadian public and professionals' perspectives.

DESIGN

A national population-based survey, the Health Care in Canada Survey.

SETTING

Canada.

PARTICIPANTS

One-thousand Canadian adults, 101 doctors, 100 nurses, 100 pharmacists and 104 administrators, randomly selected from online panels based on multiple source recruitment.

INTERVENTION

None.

MAIN OUTCOME MEASURE

Support for PCC, assessed using a summary score across seven items.

RESULTS

Of 1000 Canadian public adults surveyed, 51% were female, 74% were living with another person, and 62% had at least one chronic condition. Only 18% of health professionals were working in teams. Multivariable regression models showed that work in teams (0.24, 95%CI: 0.20, 0.28), use of e-technology (0.29, 95%CI: 0.17, 0.42), and patient older age (0.59, 95%CI: 0.32, 0.86) and involvement in decision-making (0.42, 95%CI: 0.30, 0.55) were significantly associated with higher support for PCC while lower adherence to medications (-0.81, 95%CI: -1.16, -0.47) was associated with a decreased support for attributes of PCC.

CONCLUSIONS

The findings confirmed that perceptions of requiring health professionals to work in teams and the use of technology in healthcare are associated with support for PCC from both the public and health professionals. Programs to accelerate the implementation of healthcare teams supported by information and communication technologies are needed to deliver PCC, particularly for individuals living with chronic conditions.

摘要

目的

以患者为中心的护理被推荐用于医疗服务的转变,以提高医疗保健的质量和安全性。本研究旨在评估加拿大公众和专业人士对患者为中心的护理(PCC)属性的支持的决定因素。

设计

一项全国性的基于人群的调查,即加拿大医疗保健调查。

设置

加拿大。

参与者

从基于多源招募的在线小组中随机选择的 1000 名加拿大成年人、101 名医生、100 名护士、100 名药剂师和 104 名管理人员。

干预措施

无。

主要观察指标

使用七个项目的综合评分评估对 PCC 的支持。

结果

在接受调查的 1000 名加拿大成年人中,51%为女性,74%与他人同住,62%至少有一种慢性病。只有 18%的卫生专业人员在团队中工作。多变量回归模型显示,团队工作(0.24,95%CI:0.20,0.28)、电子技术的使用(0.29,95%CI:0.17,0.42)、患者年龄较大(0.59,95%CI:0.32,0.86)和参与决策(0.42,95%CI:0.30,0.55)与对 PCC 的更高支持显著相关,而对药物的较低依从性(-0.81,95%CI:-1.16,-0.47)与对 PCC 属性的支持降低相关。

结论

研究结果证实,公众和卫生专业人员都认为需要卫生专业人员在团队中工作和在医疗保健中使用技术,这与对 PCC 的支持有关。需要加快实施由信息和通信技术支持的医疗团队的计划,以提供 PCC,特别是为患有慢性病的个人。

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