Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B3, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia.
Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B2, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia.
BMC Fam Pract. 2020 Sep 4;21(1):182. doi: 10.1186/s12875-020-01254-2.
Implementation of the new Enhanced Primary Health Care (EnPHC) intervention aims to improve service quality and experience at primary healthcare clinics; especially to newly diagnosed patients. This was achieved by restructuring and improving existing services to better manage non-communicable diseases amongst patients. Objectives of this study are to explore patients' experiences of the EnPHC intervention, to document their feedback and to determine effects of EnPHC intervention on patients.
This phenomenological qualitative study focussed on patients' experiences in relation to EnPHC interventions. Participants were purposely selected from a group of patients who attended the eight intervention primary healthcare clinics in Johor and Selangor regularly for treatment. Data collection was conducted between April to July 2018. Semi-structured interviews were conducted at average an hour per interview for four to five patients per clinic. Interviews were audio recorded, transcribed verbatim, coded and analysed using a thematic analysis approach.
A total of 35 patients participated. Analysis revealed five main themes about patient experiences receiving the EnPHC intervention. These are: (1) health assessment in disease progress monitoring, (2) patient-doctor relationship and continuity of care, (3) professionalism in service delivery, (4) ensuring compliance in achieving health targets and (5) communication skills. Each theme represents an important aspect of the service, how it should be delivered within the patient expectations and how it can improve patient's health through their lens.
Even though patients were not able to exactly identify the EnPHC intervention components implemented, they are able to describe the process changes that occurred; enabling them to improve their healthcare status. Engagement is necessary to better inform patients of the EnPHC intervention, its purpose, mechanisms, changes and importance for healthcare. It would reduce resistance and increase awareness amongst patients at the clinic.
新强化初级卫生保健（EnPHC）干预措施的实施旨在提高初级保健诊所的服务质量和体验；特别是为新诊断的患者。这是通过重组和改进现有服务来实现的，以更好地管理患者的非传染性疾病。本研究的目的是探讨患者对 EnPHC 干预的体验，记录他们的反馈，并确定 EnPHC 干预对患者的影响。
这项现象学定性研究侧重于患者对 EnPHC 干预的体验。参与者是从定期在柔佛州和雪兰莪州的 8 个干预性初级保健诊所接受治疗的患者中选择的。数据收集于 2018 年 4 月至 7 月进行。对每个诊所的四至五名患者进行了平均每个访谈一小时的半结构式访谈。访谈进行了录音、逐字记录、编码，并使用主题分析方法进行分析。
共有 35 名患者参加。分析揭示了患者接受 EnPHC 干预的五个主要主题。这些主题是：（1）疾病进展监测中的健康评估，（2）医患关系和连续性护理，（3）服务提供的专业性，（4）确保达到健康目标的合规性，（5）沟通技巧。每个主题都代表了服务的一个重要方面，它应该如何在患者的期望内提供，以及它如何通过他们的视角改善患者的健康。
尽管患者无法准确识别实施的 EnPHC 干预措施，但他们能够描述发生的流程变化；使他们能够改善他们的医疗保健状况。有必要让患者更好地了解 EnPHC 干预、其目的、机制、变化和对医疗保健的重要性。这将减少诊所患者的抵触情绪并提高他们的意识。
