Najafizada Maisam, Rahman Arifur, Oxford Katie
Memorial University of Newfoundland, St. John's, Canada.
Z Gesundh Wiss. 2023;31(3):355-367. doi: 10.1007/s10389-021-01528-8. Epub 2021 Apr 1.
The objective of this study was to identify and synthesize models of patient-centered care in Canada and compare them with the normative models described in the literature.
Patient-centered care has gained momentum in the twenty-first century as a component of quality care. During the Covid-19 pandemic, the crisis often shifts the focus to the disease rather than the patient. The multiplicity of Canadian systems, including the federal, provincial, and territorial contexts, made a good case to search for a variety of models. This study was conducted using a scoping review method supported by an environmental scan to identify patient-centered care models in Canada.
The study identified 19 patient-centered interventions across Canada. The interventions included bedside interventions, patient-engagement projects at the organizational level, and citizen advisory panels at the system level. The organizational model was the most common. The goals of interventions ranged from enhancing the patient's experience of care to identifying ways to cut costs. In most organizational-level projects, there was a marked tendency to engage patients as members of quality improvement committees. Respecting patient dignity and autonomy in one-on-one clinical interactions was minimally addressed in the models.
Health systems are not only technical, biomedical organizations but also socio-political institutions with goals of financial protection, the fair distribution of services and resources, and the meaningful inclusion of the citizens in the system, and thus patients need to be respected as individuals and as collectives within the healthcare system.
本研究的目的是识别并综合加拿大以患者为中心的护理模式,并将其与文献中描述的规范模式进行比较。
作为优质护理的一个组成部分,以患者为中心的护理在21世纪得到了发展。在新冠疫情期间,危机往往将重点转移到疾病而非患者身上。加拿大体系的多样性,包括联邦、省和地区层面,为寻找各种模式提供了充分的理由。本研究采用范围综述方法,并辅以环境扫描,以识别加拿大以患者为中心的护理模式。
该研究在加拿大确定了19种以患者为中心的干预措施。这些干预措施包括床边干预、组织层面的患者参与项目以及系统层面的公民咨询小组。组织模式最为常见。干预目标从提升患者的护理体验到寻找削减成本的方法不等。在大多数组织层面的项目中,有明显的趋势是让患者作为质量改进委员会的成员参与进来。在这些模式中,一对一临床互动中对患者尊严和自主权的尊重最少被提及。
卫生系统不仅是技术型的生物医学组织,也是具有财务保护、服务和资源公平分配以及公民有意义地融入系统等目标的社会政治机构,因此在医疗保健系统中,患者需要作为个体和集体得到尊重。