Lin Cen, Cohen Emma, Livingston Patricia M, Mohebbi Mohammadreza, Botti Mari
School of Nursing, Fudan University, Shanghai, China,
School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, Australia,
Patient Prefer Adherence. 2018 Dec 31;13:83-90. doi: 10.2147/PPA.S184373. eCollection 2019.
The subjectivity of symptom experience and the recognized role of patients in symptom management highlight the need to understand cancer patients' participation in symptom management and to identify the associations between patient participation and quality of care. However, research on patient participation has focused mostly on general healthcare activities, rather than symptom management, especially in cancer-care settings. This study aimed to compare the congruence between cancer patients' preference for and actual perceived experience of participation in symptom management and identify the relationships between preferred and actual patient participation and perceived quality of care.
This was a cross-sectional study. Patient preference and actual experience of participation in symptom management were evaluated with the modified Control Preference Scale among patients recruited from a specialized cancer hospital in China. Patients' perception of quality of care was assessed with the short-form Quality from the Patient's Perspective questionnaire.
A total of 162 patients were recruited. Their mean age was 47.5±12.2 years, and 51.9% were females. Patients' perceived actual level of participation in symptom management substantially agreed with their preference (weighted -coefficient 0.61, 95% CI 0.45-0.77). There was no significant difference between patients' perception of care quality and level of preference for participation (=0.35, =0.722) or actual experience of participation (=0.76, =0.519). Higher perceptions of quality of care were found among patients whose preferred roles were achieved (=0.007) or surpassed (=0.045).
This study identified substantial agreement between patients' preferred and actual participation, given the generally passive preference. The findings indicated that supporting patients to achieve their preferred level of participation may be more important than focusing activities on encouraging increased desire to participate for the purpose of care-quality improvement.
症状体验的主观性以及患者在症状管理中所公认的作用凸显了理解癌症患者参与症状管理的必要性,并识别患者参与度与护理质量之间的关联。然而,关于患者参与的研究大多集中在一般医疗保健活动上,而非症状管理,尤其是在癌症护理环境中。本研究旨在比较癌症患者对参与症状管理的偏好与实际感知体验之间的一致性,并确定患者偏好的参与度与实际参与度以及感知护理质量之间的关系。
这是一项横断面研究。在中国一家专业癌症医院招募的患者中,使用改良的控制偏好量表评估患者对参与症状管理的偏好和实际体验。使用患者视角的简短质量问卷评估患者对护理质量的感知。
共招募了162名患者。他们的平均年龄为47.5±12.2岁,51.9%为女性。患者对症状管理实际参与水平的感知与他们的偏好基本一致(加权系数0.61,95%可信区间0.45 - 0.77)。患者对护理质量的感知与参与偏好水平(P = 0.35,P = 0.722)或实际参与体验(P = 0.76,P = 0.519)之间没有显著差异。在那些偏好的角色得以实现(P = 0.007)或被超越(P = 0.045)的患者中,对护理质量的感知更高。
鉴于普遍存在的被动偏好,本研究发现患者偏好的参与度与实际参与度之间存在实质性一致。研究结果表明,支持患者达到其偏好的参与水平可能比专注于鼓励增加参与意愿以改善护理质量更为重要。