1 Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
2 Centre for Family Research, University of Cambridge, Cambridge, UK.
Palliat Med. 2019 Jun;33(6):663-675. doi: 10.1177/0269216319833559. Epub 2019 Mar 5.
Patients with advanced chronic obstructive pulmonary disease have difficulty reporting their holistic support needs to health care professionals, undermining delivery of person-centred care. We lack tools that directly support patients with this.
To develop an evidence-based, designed-for-purpose, tool to enable patients to directly identify and express support needs to health care professionals.
Two-stage qualitative study. Stage 1: domains of support need were identified through a systematic review, analysis of an established qualitative dataset and patient/carer focus groups. Stage 2: draft tool developed using the identified domains of need and then refined through feedback from patients, carers and health care professionals, ensuring acceptability and suitability.
SETTING/PARTICIPANTS: Stage 1 patients/carers recruited via four primary care practices and two patient support groups (East of England). Stage 2 health care professionals recruited via the Clinical Research Network and local community trust and patients/carers through two further practices and two additional support groups (East of England). In total, 57 patients, carers and health care professionals participated.
A comprehensive set of evidence-based support domains (for example: overcoming boredom or loneliness, knowing what to expect in the future) was identified and formulated into questions. The resulting tool asks patients to consider whether they need more support in 15 broad areas. Patients, carers and clinical stakeholders broadly endorsed the tool's content and wording.
The Support Needs Approach for Patients (SNAP) tool is a concise evidence-based tool designed to help patients with advanced chronic obstructive pulmonary disease identify and express their support needs to enable delivery of person-centred care.
患有晚期慢性阻塞性肺疾病的患者难以向医疗保健专业人员报告其整体支持需求,从而影响了以患者为中心的护理的实施。我们缺乏直接支持患者的工具。
开发一种基于证据、专为满足需求而设计的工具,使患者能够直接向医疗保健专业人员识别和表达支持需求。
两阶段定性研究。第 1 阶段:通过系统综述、对已建立的定性数据集的分析以及患者/护理人员焦点小组确定支持需求的领域。第 2 阶段:使用确定的需求领域开发工具草案,然后通过患者、护理人员和医疗保健专业人员的反馈进行改进,确保可接受性和适用性。
设置/参与者:第 1 阶段的患者/护理人员通过四个初级保健实践和两个患者支持团体(东英格兰)招募。第 2 阶段的医疗保健专业人员通过临床研究网络和当地社区信托以及另外两个实践和两个额外的支持团体(东英格兰)招募。共有 57 名患者、护理人员和医疗保健专业人员参与。
确定了一整套基于证据的支持领域(例如:克服无聊或孤独感、了解未来的预期)并将其制定成问题。由此产生的工具要求患者考虑他们是否需要在 15 个广泛领域获得更多支持。患者、护理人员和临床利益相关者广泛认可该工具的内容和措辞。
患者支持需求评估工具(SNAP)是一种简洁的基于证据的工具,旨在帮助患有晚期慢性阻塞性肺疾病的患者识别和表达其支持需求,从而实现以患者为中心的护理。