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以患者为中心的护理:营养师的观点和经验。

Patient-centered care: Dietitians' perspectives and experiences.

机构信息

Brigham Young University, Department of Nutrition, Dietetics & Food Science, S-231 ESC, Provo, UT 84602, USA.

Brigham Young University, Department of Statistics, 2152F WVB, Provo, UT 84602, USA.

出版信息

Patient Educ Couns. 2021 Nov;104(11):2724-2731. doi: 10.1016/j.pec.2021.04.008. Epub 2021 Apr 16.

Abstract

OBJECTIVE

To (1) explore RDNs' descriptions of patient-centered care (PCC), (2) measure Registered Dietitian Nutritionists' (RDNs) preferences for PCC and (3) identify factors that affect RDNs' PCC preferences.

METHODS

A survey instrument including two open-ended items exploring RDN descriptions of and experiences with PCC, the Patient-Practitioner Orientation Scale (PPOS), and various factors that could influence PCC (e.g., work intensification, work engagement, and work/demographic characteristics) was expert reviewed, pilot tested, and distributed electronically to 4697 RDNs. A regression analysis was conducted, and two open-ended items were qualitatively analyzed.

RESULTS

Three themes emerged when RDNs described PCC (n = 375): dietitian/patient relationship (95.7%), organizational influence (64.4%), and interprofessional teams (26.3%). RDNs (n = 318) scored 4.60/6 on the PPOS. Higher levels of work engagement were predictive of higher PPOS scores, and heavier workloads were predictive of lower PPOS scores (p < 0.05). Primary work position also influenced PPOS scores (p<0.05).

CONCLUSION

RDNs have varying personal definitions of and experiences with PCC, however there are common themes. RDNs generally prefer PCC and score moderately high on the PPOS.

PRACTICE IMPLICATIONS

To strengthen preferences for PCC, managers should create manageable workloads and prioritize work engagement. Continued emphasis on interprofessional collaboration with and organizational promotion of RDNs could improve PCC.

摘要

目的

(1)探讨注册营养师(RDN)对以患者为中心的护理(PCC)的描述,(2)衡量注册营养师(RDN)对 PCC 的偏好,(3)确定影响 RDN 对 PCC 偏好的因素。

方法

采用问卷调查法,包括两个开放式问题,分别探讨 RDN 对 PCC 的描述和体验,以及患者-医生取向量表(PPOS)和可能影响 PCC 的各种因素(如工作强度、工作投入和工作/人口统计学特征)。问卷经专家审查、试点测试后,以电子方式分发给 4697 名 RDN。进行回归分析,并对两个开放式问题进行定性分析。

结果

RDN 在描述 PCC 时出现了三个主题(n=375):营养师/患者关系(95.7%)、组织影响(64.4%)和跨专业团队(26.3%)。RDN(n=318)在 PPOS 上的得分为 4.60/6。更高的工作投入水平与更高的 PPOS 评分相关,而更重的工作量与更低的 PPOS 评分相关(p<0.05)。主要工作岗位也影响 PPOS 评分(p<0.05)。

结论

RDN 对 PCC 的定义和体验存在差异,但存在共同主题。RDN 普遍倾向于 PCC,在 PPOS 上的得分中等偏高。

实践意义

为了加强对 PCC 的偏好,管理者应创造可管理的工作量并优先考虑工作投入。继续强调与跨专业团队的合作以及组织对 RDN 的推广,可以改善 PCC。

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