Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.
School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada.
BMJ Open. 2019 Jul 30;9(7):e030005. doi: 10.1136/bmjopen-2019-030005.
Patient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients' perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population.
This study used a multiple case study design within a qualitative approach and developmental evaluation methodology. Two theoretical models, Picker's Principles of Patient-Centred Care and Valentijn's Rainbow Model of Integrated Care, guided data collection and data analysis. The thematic analysis included transcription, debriefing, codification, data display and interpretation.
This study was conducted in purposefully selected four Cree communities of Northern Quebec.
Adult patients in need of oral healthcare and who attended the local dental clinic were identified and recruited by maximum variation sampling and snowball techniques.
Patients' perspectives of patient-centred integrated oral healthcare.
Data analysis generated six major themes: enhanced accessibility, creating supportive environment, building trust through shared decision making, appreciation of public health programmes, raising oral health awareness and growing cultural humility among healthcare providers. Patients identified the integration of dental care into primary healthcare with respect to co-location, provision of free oral healthcare services, care coordination and continuity of care, referral services, developing supportive environment, shared decision making, oral health promotion and culturally competent care.
These results confirmed that patient-centred care is an important element of integrated care. Patients valued the use of this concept in all domains and levels of integration. They recommended to further strengthen the clinical integration by involving parents in oral health promotion as well as optimising care coordination and empowering a supportive environment in organisational integration.
以患者为中心的护理被认为是评估综合医疗保健的一个重要因素，并且在解决口腔健康差距方面是有效的。本研究探讨了在为魁北克北部克里族人口服务的初级保健组织中纳入口腔卫生服务的以患者为中心的综合护理中，患者对以患者为中心的综合护理的看法。
本研究采用定性方法和发展评估方法中的多个案例研究设计。Picker 的以患者为中心的护理原则和 Valentijn 的综合护理彩虹模型这两个理论模型指导了数据收集和数据分析。主题分析包括转录、汇报、编码、数据展示和解释。
本研究在魁北克北部四个有针对性选择的克里社区进行。
需要口腔保健的成年患者，并通过最大变异抽样和滚雪球技术被招募到当地的牙科诊所。
患者对以患者为中心的综合口腔保健的看法。
数据分析产生了六个主要主题：增强可及性、创造支持性环境、通过共同决策建立信任、对公共卫生计划的赞赏、提高口腔健康意识以及在医疗保健提供者中培养文化谦逊。患者确定了将牙科护理与初级保健相结合，包括共同定位、提供免费口腔保健服务、护理协调和连续性、转介服务、发展支持性环境、共同决策、口腔健康促进和文化能力。
这些结果证实了以患者为中心的护理是综合护理的一个重要组成部分。患者重视在所有整合领域和层面使用这一概念。他们建议进一步加强临床整合，让父母参与口腔健康促进，优化护理协调，并在组织整合中赋予支持性环境权力。
