University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands.
Patient Educ Couns. 2021 Sep;104(9):2358-2363. doi: 10.1016/j.pec.2021.02.044. Epub 2021 Feb 27.
For shared decision making, it is crucial to identify patients' priorities regarding health outcomes. Our aim was to study whether healthcare professionals know these priorities.
In this cross-sectional study we included older patients who had to make a treatment decision, their general practitioners (GPs) and their medical specialists. Agreement between the patients' main health outcome as prioritised by using the Outcome Prioritization Tool (OPT) and the perception of the same outcome by their healthcare professionals.
Eighty-seven patients were included. Median age was 76 years, 87.4% of patients presented with malignant disease. The majority prioritised maintaining independence (51.7%), followed by extending life (27.6%). The agreement between patients and healthcare professionals was low (GPs 41.7%, kappa 0.067, p = 0.39), medical specialists 40.3%, kappa 0.074, p = 0.33). Positively related to agreement was patient's age > 75, and a longer relation with their patients (for GPs), and the patient having no partner (for medical specialist). Having a malignant disease, dependent living and functional deficits were negatively related to agreement.
Healthcare professionals have poor perceptions of their patients' priorities.
To realise patient-centered care, it is crucial to discuss priorities explicitly with all patients.
对于共同决策，确定患者对健康结果的优先事项至关重要。我们的目的是研究医疗保健专业人员是否了解这些优先事项。
在这项横断面研究中，我们纳入了需要做出治疗决策的老年患者、他们的全科医生（GP）和他们的医学专家。使用结果优先排序工具（OPT）对患者的主要健康结果进行优先排序，并将其与医疗保健专业人员对同一结果的看法进行比较。
共纳入 87 名患者。中位年龄为 76 岁，87.4%的患者患有恶性疾病。大多数患者将保持独立（51.7%）作为首要目标，其次是延长生命（27.6%）。患者和医疗保健专业人员之间的一致性较低（GP 为 41.7%，kappa 值为 0.067，p=0.39），医学专家为 40.3%，kappa 值为 0.074，p=0.33）。一致性与患者年龄>75 岁、与患者的关系时间较长（对于 GP）以及患者没有伴侣（对于医学专家）呈正相关。患有恶性疾病、生活依赖和功能缺陷与一致性呈负相关。
医疗保健专业人员对患者优先事项的看法较差。
为了实现以患者为中心的护理，与所有患者明确讨论优先事项至关重要。
