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患者在专科咨询中的辅导。哪些患者对教练感兴趣,他们认为有哪些沟通障碍?

Patient coaching in specialist consultations. Which patients are interested in a coach and what communication barriers do they perceive?

机构信息

Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands; Windesheim University of Applied Sciences, Zwolle, the Netherlands.

Dept. of Medical Psychology Academic Medical Centre University of Amsterdam, the Netherlands.

出版信息

Patient Educ Couns. 2019 Aug;102(8):1520-1527. doi: 10.1016/j.pec.2019.03.011. Epub 2019 Mar 18.

Abstract

OBJECTIVE

To characterize patients interested in support by a patient coach to guide them in medical specialist consultations.

METHODS

We compared 76 patients interested in a patient coach with 381 patients without such an interest, using a representative panel of patients with a chronic disease in the Netherlands. Independent variables were demographic factors, socio-economic status, perceived efficacy in patient-provider interaction, communication barriers, health literacy, (duration and type of) disease(s) and activation level.

RESULTS

In univariate analyses, patients who are interested in a coach were significantly older, had lower health literacy skills and less self-efficacy and, overall, experienced more communication barriers (>4), than patients without such interest (1-2 barriers). Multivariate analyses indicated three communications barriers as determinants of patient interest in a coach: feeling tense, uncertainty about own understanding, and believing that a certain topic is not part of a healthcare providers' task.

CONCLUSION

Patients interested in a coach perceive specific barriers in communicating with their medical specialist. In addition, patients who are > = 65 years, have lower health literacy and low self-efficacy may have interest in a coach.

PRACTICE IMPLICATIONS

Characterizing patients interested in a patient coach facilitates identification of those who could benefit from such a coach in clinical practice.

摘要

目的

描述对患者教练进行支持以指导他们与医学专家进行咨询的患者的特征。

方法

我们使用荷兰具有代表性的慢性病患者小组,将 76 名对患者教练感兴趣的患者与 381 名没有此类兴趣的患者进行了比较。自变量为人口统计学因素、社会经济地位、在医患互动中感知的效能、沟通障碍、健康素养、(疾病的)持续时间和类型以及激活水平。

结果

在单变量分析中,与没有此类兴趣的患者(1-2 个障碍)相比,对教练感兴趣的患者年龄较大,健康素养技能较低,自我效能感较低,并且总体上经历了更多的沟通障碍(> 4 个)。多变量分析表明,有三个沟通障碍是患者对教练感兴趣的决定因素:感到紧张、对自己的理解不确定,以及认为某个话题不属于医疗保健提供者的任务。

结论

对教练感兴趣的患者在与他们的医学专家交流时会遇到特定的障碍。此外,年龄≥ 65 岁、健康素养较低和自我效能感较低的患者可能对教练感兴趣。

实践意义

对患者教练感兴趣的患者的特征描述有助于在临床实践中确定那些可能从教练中受益的患者。

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