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以患者为中心的全科医生护理:对患者和提供者的经验和看法的定性调查。

Patient-centred care delivered by general practitioners: a qualitative investigation of the experiences and perceptions of patients and providers.

机构信息

School of Allied Health Sciences, Griffith University Menzies Health Institute Queensland, Gold Coast, Queensland, Australia

School of Allied Health Sciences, Griffith University Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.

出版信息

BMJ Qual Saf. 2022 Mar;31(3):191-198. doi: 10.1136/bmjqs-2020-011236. Epub 2020 Dec 10.

Abstract

BACKGROUND

Patient-centred care (PCC) is care that is respectful and responsive to the wishes of patients. The body of literature on PCC delivered by general practitioners (GPs) has increased steadily over time. There is an opportunity to advance the work on GP-delivered PCC through qualitative research involving both patients and providers.

AIM

To explore the perceptions and experiences of PCC by patient advocates and GPs.

DESIGN AND SETTING

Qualitative description in a social constructivist paradigm. Participants were sampled from six primary care organisations in south east Queensland/northern New South Wales, Australia.

METHOD

Purposive sampling was used to recruit English-speaking adult participants who were either practising GPs or patient advocates. Focus group sessions explored participants' perceptions and experiences of PCC. Data were analysed thematically using a constant-comparative approach.

RESULTS

Three focus groups with 15 patient advocates and three focus groups with 12 practising GPs were conducted before thematic saturation was obtained. Five themes emerged: (1) understanding of PCC is varied and personal, (2) valuing humanistic care, (3) considering the system and collaborating in care, (4) optimising the general practice environment and (5) needing support for PCC that is embedded into training.

CONCLUSION

Patient advocates' and GPs' understanding of PCC are diverse, which can hinder strategies to implement and sustain PCC improvements. Future research should explore novel interventions that expose GPs to unique feedback from patients, assess the patient-centeredness of the environment and promote GP self-reflection on PCC.

摘要

背景

以患者为中心的护理(PCC)是指尊重和回应患者意愿的护理。关于全科医生(GP)提供的以患者为中心的护理的文献数量随着时间的推移稳步增加。通过涉及患者和提供者的定性研究,为推进 GP 提供的以患者为中心的护理工作提供了机会。

目的

探讨患者倡导人和全科医生对以患者为中心的护理的看法和经验。

设计和设置

社会建构主义范式中的定性描述。参与者是从澳大利亚昆士兰州东南部/新南威尔士州北部的六个初级保健组织中抽样的。

方法

采用目的性抽样,招募讲英语的成年参与者,他们要么是执业全科医生,要么是患者倡导人。焦点小组会议探讨了参与者对以患者为中心的护理的看法和经验。使用恒定比较方法对数据进行主题分析。

结果

在获得主题饱和之前,进行了三次有 15 名患者倡导人和三次有 12 名执业全科医生参加的焦点小组。出现了五个主题:(1)对以患者为中心的护理的理解是多样的和个人的,(2)重视人文关怀,(3)考虑系统并在护理中合作,(4)优化一般实践环境,(5)需要将以患者为中心的护理嵌入培训的支持。

结论

患者倡导人和全科医生对以患者为中心的护理的理解是多样的,这可能会阻碍实施和维持以患者为中心的护理改进的策略。未来的研究应该探索新的干预措施,使全科医生接触到来自患者的独特反馈,评估环境的以患者为中心程度,并促进全科医生对以患者为中心的护理进行自我反思。

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