van Leersum Catharina M, van Steenkiste Ben, Moser Albine, Wolf Judith R L M, van der Weijden Trudy
Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, the Netherlands.
Research Center for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, the Netherlands.
Patient Prefer Adherence. 2020 Aug 25;14:1553-1566. doi: 10.2147/PPA.S257501. eCollection 2020.
Collaborative deliberation comprises personal engagement, recognition of alternative actions, comparative learning, preference elicitation, and preference integration. Collaborative deliberation may be improved by assisting preference elicitation during shared decision-making. This study proposes a framework for preference elicitation to facilitate collaborative deliberation in long-term care consultations.
First, a literature overview was conducted comprising current models for the elicitation of preferences in health and social care settings. The models were reviewed and compared. Second, qualitative research was applied to explore those issues that matter most to clients in long-term care. Data were collected from clients in long-term care, comprising 16 interviews, 3 focus groups, 79 client records, and 200 online client reports. The qualitative analysis followed a deductive approach. The results of the literature overview and qualitative research were combined.
Based on the literature overview, five overarching domains of preferences were described: "Health", "Daily life", "Family and friends", "Living conditions", and "Finances". The credibility of these domains was confirmed by qualitative data analysis. During interviews, clients addressed issues that matter in their lives, including a "click" with their care professional, safety, contact with loved ones, and assistance with daily structure and activities. These data were used to determine the content of the domains.
A framework for preference elicitation in long-term care is proposed. This framework could be useful for clients and professionals in preference elicitation during collaborative deliberation.
协作审议包括个人参与、对替代行动的认识、比较学习、偏好引出和偏好整合。在共同决策过程中协助偏好引出可能会改善协作审议。本研究提出了一个偏好引出框架，以促进长期护理咨询中的协作审议。
首先，对健康和社会护理环境中当前的偏好引出模型进行了文献综述。对这些模型进行了审查和比较。其次，应用定性研究来探索对长期护理客户最重要的问题。从长期护理客户中收集数据，包括16次访谈、3个焦点小组、79份客户记录和200份在线客户报告。定性分析采用演绎法。将文献综述和定性研究的结果结合起来。
基于文献综述，描述了偏好的五个总体领域：“健康”、“日常生活”、“家人和朋友”、“生活条件”和“财务”。这些领域的可信度通过定性数据分析得到了证实。在访谈中，客户谈到了他们生活中重要的问题，包括与护理专业人员的“合拍”、安全、与亲人的联系以及日常结构和活动的协助。这些数据被用来确定领域的内容。
提出了一个长期护理偏好引出框架。该框架可能对客户和专业人员在协作审议过程中的偏好引出有用。
