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[智利初级卫生保健中用户参与临床决策 智利初级卫生保健中用户参与临床决策]

[User Participation in Clinical Decision-making in Primary Health Care in ChileParticipação dos usuários nas decisões clínicas na atenção primária à saúde no Chile].

作者信息

Bravo Paulina, Dois Angelina, Contreras Aixa, Soto Gabriela, Mora Isabel

机构信息

Departamento de Salud de la Mujer, Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile.

Departamento de Salud del Adulto y Senescente, Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Rev Panam Salud Publica. 2018 Sep 24;42:e133. doi: 10.26633/RPSP.2018.133. eCollection 2018.

Abstract

OBJECTIVE

Describe users' experience with participation in clinical decision-making at Family Health Centers (CESFAM) in the Primary Health Care (PHC) system.

METHODS

Qualitative descriptive study. Focus groups made up of CESFAM users were held in southeastern Santiago, Chile, and the information was thematically analyzed using Atlas.ti version 6 software.

RESULTS

Five focus groups were held (n = 41). The main themes that emerged from the discussions were the passive role of users in decisions and delegated decision-making, based on their trust in the health professional. Users' passive role limits their opportunities for participation in clinical decision-making, ceding power to the health professional. However, establishing a therapeutic partnership allows users to feel that they are being treated as unique individuals whom the professional listens to and respects, ensuring that the decisions of the health team can be trusted, since they look out for the users' real interests.

CONCLUSION

Users' participation in clinical encounters is still limited in Chile. However, bolstering that participation is essential for increasing user satisfaction and promoting people-centered care.

摘要

目的

描述初级卫生保健(PHC)系统中家庭健康中心(CESFAM)的用户参与临床决策的体验。

方法

定性描述性研究。在智利圣地亚哥东南部召集了由CESFAM用户组成的焦点小组,并使用Atlas.ti 6版软件对信息进行了主题分析。

结果

举行了5个焦点小组(n = 41)。讨论中出现的主要主题是用户在决策中的被动角色以及基于对卫生专业人员的信任而进行的委托决策。用户的被动角色限制了他们参与临床决策的机会,将权力让渡给了卫生专业人员。然而,建立治疗性伙伴关系能让用户感到自己被视为独特的个体,受到专业人员的倾听和尊重,从而确保可以信任卫生团队的决策,因为这些决策关注用户的实际利益。

结论

在智利,用户参与临床诊疗的程度仍然有限。然而,加强这种参与对于提高用户满意度和促进以患者为中心的护理至关重要。

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