University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720976235. doi: 10.1177/2150132720976235.
When making medical care more patient-centered, surveys on patients' and their relatives' experiences can be helpful in identifying opportunities for improvement. In cases where the targeted patients are unable to express their own perspective, for example, due to them being too young or suffering from severe impairments, proxies can serve as substitutes. Proxies are frequently used in care planning and consent. Nevertheless, it is unclear whether patients' assessments of how patient-centered their medical care is are similar to those of their proxies. This study aims to assess the level of consistency between patients' and their proxies' assessments using an adapted version of the Patient Assessment of Chronic Illness Care (PACIC) short form questionnaire.
In a cross-sectional study, patients with coronary heart disease were recruited at cardiologists' offices, rehabilitation clinics and hospitals. Participants were surveyed with regard to the perceived level of patient-centeredness during their care using an adapted version of the German PACIC short form (PACIC-S11.1). Correlations in the assessments made by each patient and their respective proxy were analyzed. On the level of the patients group and the relatives group differences between mean ratings for each item were compared using paired -tests.
In total, 74 pairs of patients and proxies submitted the completed questionnaire. On the level of the individual patient/proxy pairs, no correlation, or significant but low correlation, was found between the ratings. On the group level, patients' and their proxies' item ratings were similar in the interpretation of averages, but still demonstrated statistically significant differences. Overall, patients rated their care as more patient-centered than their proxies did.
The study shows that, on the individual level, proxies' ratings do not necessarily reflect the patients' assessment of PCC. On the group level, the assessments of relatives regarding PCC are similar to those of the patients.
German clinical trials register (Deutsches Register Klinischer Studien, DRKS) Registration Number: DRKS00012434 (URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012434).
在使医疗服务更加以患者为中心的过程中，调查患者及其家属的体验有助于发现改进的机会。在目标患者无法表达自己的观点的情况下，例如由于他们太年轻或患有严重的损伤，代理人可以作为替代品。代理人经常在护理计划和同意书中使用。然而，尚不清楚患者对其医疗服务的以患者为中心程度的评估与代理人的评估是否相似。本研究旨在使用经过改编的慢性病患者护理评估量表（PACIC）短表评估患者及其代理人评估之间的一致性程度。
在一项横断面研究中，在心脏病专家办公室、康复诊所和医院招募了冠心病患者。使用经过改编的德国 PACIC 短表（PACIC-S11.1）对每位患者就其护理过程中感知的以患者为中心程度进行调查。分析了每位患者及其各自代理人的评估之间的相关性。在患者组和亲属组的水平上，使用配对 t 检验比较了每个项目的平均评分之间的差异。
共有 74 对患者及其代理人提交了完成的问卷。在个体患者/代理人对的水平上，评分之间没有相关性，或者相关性虽然显著但很低。在组的水平上，患者及其代理人的项目评分在平均值的解释上相似，但仍存在统计学差异。总体而言，患者对其护理的评价比代理人更以患者为中心。
该研究表明，在个体水平上，代理人的评分不一定反映患者对 PCC 的评估。在组的水平上，亲属对 PCC 的评估与患者相似。
德国临床试验注册处（Deutsches Register Klinischer Studien，DRKS）注册号：DRKS00012434（网址：https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012434）。
