Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
Women's College Hospital Research Institute, Women's College Hospital, Toronto, Canada.
Patient Educ Couns. 2020 Jul;103(7):1422-1427. doi: 10.1016/j.pec.2020.02.008. Epub 2020 Feb 10.
Patient-centred care (PCC) is one approach for mitigating gendered inequities in health care quality. Little is known about how to implement PCC for women (PCCW). This study explored women's views about PCCW implementation.
Descriptive analysis of semi-structured qualitative telephone interviews with diverse women about PCC using an established 6-domain PCC framework.
Participants were 33 women who varied in health care experience, age, education and setting. Themes were consistent across these characteristics. Women said that clinicians often dismissed their healthcare concerns. We transformed desired PCC elements into strategies to implement PCCW, 27 at the point-of-care (i.e. assume a non-judgmental disposition, demonstrate active listening, elicit questions, acknowledge emotions, explore preferences for treatment, and offer self-care information) and 3 at the system level (education for women/girls and clinicians about PCCW, widespread access to women's-only services or women clinicians).
Many women experienced suboptimal PCC. By sharing their PCC experiences, women identified PCC elements of importance to them, and insight on actionable point-of-care and system-level strategies to implement PCCW.
This study revealed numerous ways that clinicians can foster PCCW, and insight on how healthcare managers and policy-makers can support PCCW implementation.
以患者为中心的护理（PCC）是减轻医疗保健质量中性别不平等的一种方法。对于如何为女性实施 PCC（PCCW），知之甚少。本研究探讨了女性对 PCCW 实施的看法。
使用既定的 6 个 PCC 框架，对不同健康护理经验、年龄、教育和环境的女性进行半结构化定性电话访谈，对 PCC 进行描述性分析。
参与者为 33 名女性，她们在医疗保健经验、年龄、教育和环境方面存在差异。主题在这些特征上是一致的。女性表示，临床医生经常忽视她们的医疗保健问题。我们将期望的 PCC 要素转化为实施 PCCW 的策略，27 个策略是在护理点实施的（即假设非评判性的态度、表现出积极倾听、引出问题、承认情绪、探索治疗偏好，并提供自我保健信息），3 个策略是在系统层面实施的（为女性/女孩和临床医生提供关于 PCCW 的教育、广泛获得仅限女性的服务或女性临床医生）。
许多女性经历了不尽如人意的 PCC。通过分享他们的 PCC 经验，女性确定了对她们重要的 PCC 要素，以及实施 PCCW 的可操作护理点和系统层面策略的见解。
本研究揭示了临床医生可以促进 PCCW 的多种方式，以及医疗保健管理人员和政策制定者如何支持 PCCW 实施的见解。
