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我现在可以见你了,医生!在初级保健中实施 Let's Discuss Health 网站的混合方法研究。

I am ready to see you now, Doctor! A mixed-method study of the Let's Discuss Health website implementation in Primary Care.

机构信息

Department of Family Medicine and Emergency Medicine, University of Montreal, Montreal, QC, Canada.

Laval Integrated Health and Social Services Centre (Centre de santé et des services sociaux de Laval), Groupe de recherche sur les transformations des pratiques cliniques et organisationnelles, Laval, QC, Canada.

出版信息

Health Expect. 2021 Apr;24(2):243-256. doi: 10.1111/hex.13158. Epub 2020 Dec 7.

Abstract

BACKGROUND

Let's Discuss Health (LDH) is a website that encourages patients to prepare their health-care encounters by providing communication training, review of topics and questions that are important to them.

OBJECTIVE

To describe LDH implementation during primary care (PC) visits for chronic illnesses.

METHODS

Design: Descriptive mixed-method study.

SETTING

6 PC clinics.

PARTICIPANTS

156 patients and 51 health-care providers (HCP).

INTERVENTION

LDH website implementation.

OUTCOME MEASURES

Perceived quality and usefulness of LDH; perceived quality of HCP-patient communication; patient activation; LDH integration in routine PC practices and barriers to its use.

RESULTS

Patients reported a positive perception of the website in that it helped them to adopt an active role in the encounters; recall their visit agenda and reduce encounter-related stress; feel more confident to ask questions, feel more motivated to prepare their future medical visits and improve their chronic illness management. However, a certain disconnect emerged between HCP and patient perceptions as to the value of LDH in promoting a sense of partnership and collaboration. The main barriers to the use of LDH are HCP lack of interest, limited access to technology, lack of time and language barriers.

CONCLUSION

Our findings indicate that it is advantageous for patients to prepare their medical encounters. However, the study needs to be replicated in other medical environments using larger and more diverse samples.

PATIENT AND PUBLIC CONTRIBUTION

Patient partners were involved in the conduct of this study.

摘要

背景

Let's Discuss Health(LDH)是一个网站,通过提供沟通培训、回顾对患者重要的话题和问题,鼓励患者为他们的医疗保健就诊做准备。

目的

描述 LDH 在慢性病的初级保健(PC)就诊中的实施情况。

方法

设计:描述性混合方法研究。

设置

6 个 PC 诊所。

参与者

156 名患者和 51 名医疗保健提供者(HCP)。

干预措施

LDH 网站的实施。

结果测量

对 LDH 的感知质量和有用性;感知 HCP-患者沟通质量;患者激活;LDH 在常规 PC 实践中的整合以及使用的障碍。

结果

患者对该网站的评价积极,认为该网站帮助他们在就诊中采取积极主动的角色;回忆他们的就诊议程并减轻就诊相关的压力;更有信心提问,更有动力准备未来的就诊并改善他们的慢性病管理。然而,HCP 和患者对 LDH 在促进合作和协作感方面的价值存在一定的脱节。使用 LDH 的主要障碍是 HCP 缺乏兴趣、技术获取有限、缺乏时间和语言障碍。

结论

我们的研究结果表明,患者准备他们的医疗就诊是有利的。然而,需要在其他医疗环境中使用更大和更多样化的样本进行复制。

患者和公众的贡献

患者伙伴参与了这项研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daa2/8077096/f398659a1440/HEX-24-243-g003.jpg

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