Brickley Bryce, Williams Lauren T, Morgan Mark, Ross Alyson, Trigger Kellie, Ball Lauren
Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
Bond University, Gold Coast, QLD, Australia.
BMC Health Serv Res. 2021 Mar 20;21(1):261. doi: 10.1186/s12913-021-06273-y.
Patients, providers and health care organisations benefit from an increased understanding and implementation of patient-centred care (PCC) by general practitioners (GPs). This study aimed to evaluate and advance a theoretical model of PCC developed in consultation with practising GPs and patient advocates.
Qualitative description in a social constructivist/interpretivist paradigm. Participants were purposively sampled from six primary care organisations in south east Queensland/northern New South Wales, Australia. Participants engaged in focus group discussions where they expressed their perceptions, views and feelings of an existing PCC model. Data was analysed thematically using a constant-comparison approach.
Three focus groups with 15 patient advocates and three focus groups with 12 GPs were conducted before thematic saturation was obtained. Three themes emerged: i) the model represents the ideal, ii) considering the system and collaborating in care and iii) optimising the general practice environment. The themes related to participants' impression of the model and new components of PCC perceived to be experienced in the 'real world'. The data was synthesised to produce an advanced model of PCC named, "Putting Patients First: A Map for PCC".
Our revised PCC model represents an enhanced understanding of PCC in the 'real world' and can be used to inform patients, providers and health organisations striving for PCC. Qualitative testing advanced and supported the credibility of the model and expanded its application beyond the doctor-patient encounter. Future work could incorporate our map for PCC in tool/tool kits designed to support GPs and general practice with PCC.
患者、医疗服务提供者和医疗保健组织可从全科医生（GP）对以患者为中心的护理（PCC）的更多理解和实施中受益。本研究旨在评估并推进一个与执业全科医生和患者权益倡导者协商制定的PCC理论模型。
采用社会建构主义/解释主义范式进行定性描述。参与者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进行有目的抽样。参与者参与焦点小组讨论，在讨论中他们表达了对现有PCC模型的看法、观点和感受。使用持续比较法对数据进行主题分析。
在达到主题饱和之前，开展了三个有15名患者权益倡导者参与的焦点小组和三个有12名全科医生参与的焦点小组。出现了三个主题：i）该模型代表了理想状态，ii）考虑系统并在护理中进行协作，以及iii）优化全科医疗环境。这些主题与参与者对该模型的印象以及被认为在“现实世界”中会体验到的PCC新组成部分有关。对数据进行综合以产生一个名为“将患者放在首位：PCC地图”的PCC高级模型。
我们修订后的PCC模型代表了对“现实世界”中PCC的进一步理解，可用于为追求PCC的患者、医疗服务提供者和卫生组织提供信息。定性测试推进并支持了该模型的可信度，并将其应用扩展到医患互动之外。未来的工作可以将我们的PCC地图纳入旨在支持全科医生和全科医疗实施PCC的工具/工具包中。
