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美国成年人以患者为中心的沟通的预测因素:对 2017-2018 年健康信息国家趋势调查(HINTS)的分析。

Predictors of Patient-Centered Communication among U.S. Adults: Analysis of the 2017-2018 Health Information National Trends Survey (HINTS).

机构信息

Behavioral Research Program, Health Communication and Informatics Research Branch, National Cancer Institute, Rockville, MD USA.

Behavioral Research Program, Office of the Associate Director, National Cancer Institute, Rockville, MD USA.

出版信息

J Health Commun. 2021 Jan 2;26(1):57-64. doi: 10.1080/10810730.2021.1878400. Epub 2021 Mar 1.

Abstract

An essential component of patient-centered care is the communication between patients and their providers, which can affect patients' health outcomes A cancer care model, developed by Epstein and Street, includes a multi-dimensional patient-centered communication (PCC) framework with six functions: foster healing relationships, exchange information, respond to emotions, manage uncertainty, make decisions, and enable patient self-management. Seven domains that describe the functions were included on the Health Information National Trends Survey (HINTS) to assess PCC. We examined the association between sociodemographic and health-related factors and PCC as well as how U.S. adults, by different age groups, ranked different domains of PCC.Nationally representative data (n = 5,738) from 2017 to 2018 HINTS were merged to examine predictors of PCC among U.S. adults. Weighted statistics describe the study sample and prevalence for ratings of PCC domains. A multivariate linear regression model was computed to assess associations among predictors and PCC.Participants rated their communication with doctors in the last year with an overall mean of 80 out of 100. Older age, those reporting excellent health, and those with higher confidence in taking care of one's health predicted better PCC. Individuals who reported being non-Hispanic Asian and having lower household income were associated with poorer communication. Participants' lowest rating of PCC concentrated on providers dealing with their emotional needs.Findings suggest that many patients do not feel that their providers adequately manage, communicate, nor respond to their emotional needs. Future efforts should enhance interpersonal exchanges among sub-populations who report poorer communication with providers during clinical visits.

摘要

以患者为中心的护理的一个重要组成部分是患者与其提供者之间的沟通,这会影响患者的健康结果。爱泼斯坦(Epstein)和斯特里特(Street)开发的癌症护理模式包括一个多维的以患者为中心的沟通(PCC)框架,具有六个功能:培养治疗关系、交流信息、回应情绪、管理不确定性、做出决策和促进患者自我管理。健康信息国家趋势调查(HINTS)包括七个描述功能的领域,用于评估 PCC。我们研究了社会人口和健康相关因素与 PCC 之间的关系,以及美国成年人按不同年龄组对 PCC 不同领域的排名。将 2017 年至 2018 年 HINTS 的全国代表性数据(n=5738)合并,以检验美国成年人 PCC 的预测因素。加权统计数据描述了研究样本和 PCC 领域评分的流行率。计算了多变量线性回归模型以评估预测因素与 PCC 之间的关联。参与者对上一年与医生的沟通进行了总体评分,平均得分为 100 分中的 80 分。年龄较大、报告健康状况极佳和对自己的健康护理更有信心的人预测 PCC 更好。报告自己是非西班牙裔亚裔和家庭收入较低的人沟通较差。参与者对 PCC 的最低评分集中在提供者满足他们的情感需求上。研究结果表明,许多患者认为他们的提供者没有充分管理、沟通或回应他们的情感需求。未来的工作应该加强在临床就诊期间与提供者沟通较差的亚人群之间的人际交流。

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