患者与营养师对以患者为中心的照护的认知比较：一项横断面调查。
A comparison of patients' and dietitians' perceptions of patient-centred care: A cross-sectional survey.
机构信息
Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia.
出版信息
Health Expect. 2019 Jun;22(3):457-464. doi: 10.1111/hex.12868. Epub 2019 Jan 22.
AIM
The aim of this study was to compare patients' and dietitians' perceptions of patient-centred care (PCC) in dietetic practice.
METHODS
Participants were as follows: (a) adult patients who had attended ≥1 individual dietetic consultation with an Accredited Practicing Dietitian (APD) working in primary care; and (b) APDs with experience working in primary care. A cross-sectional survey was undertaken using a patient- and dietitian-reported inventory to measure PCC in dietetic practice. The inventory comprised of five previously validated scales: The Communication Assessment Tool; the 9-item Shared Decision-Making Questionnaire; the Patient-Doctor Depth of Relationship Scale; the Schmidt Perception of Nursing Care Scale-Seeing the Individual Patient sub-scale; and the Person-Centred Practice Inventory-Staff -Providing Holistic Care sub-scale. Descriptive statistics were used to analyse participant characteristics and to compute total scores for the five scales. The Mann-Whitney U test was used to compare median scores between patients and dietitians.
RESULTS
One-hundred and thirty-three patients and 180 dietitians completed the survey. Patients reported significantly higher scores compared to dietitians for "shared decision-making" (P = 0.004), but significantly lower scores for "providing holistic and individualized care" (P = 0.005), "knowing the patient/dietitian" (P = 0.001) and "caring patient-dietitian relationships" (P =0.009).
CONCLUSION
This study highlighted potentially important differences between patients' and dietitians' perceptions of PCC and identified key aspects of dietetic care requiring practice improvements. Strategies are needed to bridge gaps between dietitians' and patients' perceptions and enhance PCC in dietetic practice. These findings suggest that dietitians should focus on individualizing nutrition care, gaining a holistic understanding of their patients and knowing/understanding each patient.
目的
本研究旨在比较患者和营养师对饮食实践中以患者为中心的护理（PCC）的看法。
方法
参与者如下：（a）参加过≥1 次与在初级保健中工作的认证执业营养师（APD）进行的个体饮食咨询的成年患者；（b）有在初级保健中工作经验的 APD。使用患者和营养师报告的清单进行横断面调查，以衡量饮食实践中的 PCC。清单包括五个先前经过验证的量表：沟通评估工具；9 项共享决策问卷；患者-医生关系深度量表；施密特护理感知量表-看到个体患者子量表；以及以人为中心的实践清单-提供整体护理员工子量表。使用描述性统计数据分析参与者特征，并计算五个量表的总分。使用 Mann-Whitney U 检验比较患者和营养师的中位数得分。
结果
133 名患者和 180 名营养师完成了调查。与营养师相比，患者在“共享决策”方面的得分明显更高（P=0.004），但在“提供整体和个性化护理”（P=0.005）、“了解患者/营养师”（P=0.001）和“关心患者-营养师关系”（P=0.009）方面的得分明显更低。
结论
本研究强调了患者和营养师对 PCC 的看法之间可能存在的重要差异，并确定了需要改进实践的饮食护理的关键方面。需要采取策略来弥合营养师和患者看法之间的差距，加强饮食实践中的 PCC。这些发现表明，营养师应专注于个性化营养护理，全面了解患者，并了解/理解每位患者。
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