Foo Chuan De, Tan Yan Lin, Shrestha Pami, Eh Ke Xin, Ang Ian Yi Han, Nurjono Milawaty, Toh Sue-Anne, Shiraz Farah
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Singapore Population Health Improvement Centre (SPHERiC), National University Health System, Singapore, Singapore.
PLoS One. 2020 Nov 25;15(11):e0242610. doi: 10.1371/journal.pone.0242610. eCollection 2020.
The aim of this study is to explore patients' experiences with community-based care programmes (CCPs) and develop dimensions of patient experience salient to community-based care in Singapore. Most countries like Singapore are transforming its healthcare system from a hospital-centric model to a person-centered community-based care model to better manage the increasing chronic disease burden resulting from an ageing population. It is thus critical to understand the impact of hospital to community transitions from the patients' perspective. The exploration of patient experience will guide the development of an instrument for the evaluation of CCPs for quality improvement purposes.
A qualitative exploratory study was conducted where face-to-face in-depth interviews were conducted using a purposive sampling method with patients enrolled in CCPs. In total, 64 participants aged between 41 to 94 years were recruited. A deductive framework was developed using the Picker Patient Experience instrument to guide our analysis. Inductive coding was also conducted which resulted in emergence of new themes.
Our findings highlighted eight key themes of patient experience: i) ensuring care continuity, ii) involvement of family, iii) access to emotional support, vi) ensuring physical comfort, v) coordination of services between providers, vi) providing patient education, vii) importance of respect for patients, and viii) healthcare financing.
Our results demonstrated that patient experience is multi-faceted, and dimensions of patient experience vary according to healthcare settings. As most patient experience frameworks were developed based on a single care setting in western populations, our findings can inform the development of a culturally relevant instrument to measure patient experience of community-based care for a multi-ethnic Asian context.
本研究旨在探索患者参与社区护理项目（CCP）的经历，并确定新加坡社区护理中患者体验的显著维度。像新加坡这样的大多数国家正在将其医疗体系从以医院为中心的模式转变为以患者为中心的社区护理模式，以更好地应对因人口老龄化导致的慢性病负担不断增加的问题。因此，从患者的角度理解医院向社区过渡的影响至关重要。对患者体验的探索将指导开发一种用于评估社区护理项目以提高质量的工具。
进行了一项定性探索性研究，采用目的抽样法对参与社区护理项目的患者进行面对面深入访谈。总共招募了64名年龄在41至94岁之间的参与者。使用Picker患者体验工具开发了一个演绎框架来指导我们的分析。还进行了归纳编码，从而出现了新的主题。
我们的研究结果突出了患者体验的八个关键主题：i）确保护理连续性，ii）家庭参与，iii）获得情感支持，vi）确保身体舒适，v）提供者之间的服务协调，vi）提供患者教育，vii）尊重患者的重要性，以及viii）医疗融资。
我们的结果表明，患者体验是多方面的，并且患者体验的维度因医疗环境而异。由于大多数患者体验框架是基于西方人群的单一护理环境开发的，我们的研究结果可为开发一种在文化上相关的工具提供参考，以衡量多民族亚洲背景下社区护理的患者体验。
