从健康专业人员和服务消费者角度看老年糖尿病患者的个性化医疗保健
Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers.
作者信息
Bartkeviciute Birute, Lesauskaite Vita, Riklikiene Olga
机构信息
Faculty of Nursing, Lithuanian University of Health Sciences, LT 44307 Kaunas, Lithuania.
出版信息
J Pers Med. 2021 Jun 27;11(7):608. doi: 10.3390/jpm11070608.
BACKGROUND
Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient's clinical situation, personal life situation, and decisional control.
METHODS
The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, = 70) and older diabetes patients ( = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy.
RESULTS
The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals' perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients' ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals' and patients' samples, related to the personal life situation sub-scale.
CONCLUSIONS
Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients' understanding and experience of individuality in care.
背景
个体化护理作为一种以患者为中心的护理方式，在医疗保健领域是一种广为人知的方法，被组织和专业人员视为最佳实践，但在日常实践中的实施却带来了严峻挑战。本研究旨在评估和比较医疗专业人员和老年糖尿病患者对患者临床状况、个人生活状况和决策控制权方面的个体化护理的看法。
方法
采用横断面调查设计的定量研究于2019年3月至2021年1月进行。使用个体化护理量表收集数据。医疗专业人员（护士和医生，n = 70）和老年糖尿病患者（n = 145）参与了研究。糖尿病平均病程为15.8年（标准差 = 10.0），2型糖尿病最为常见（89.0%）。51.0%的患者当前的降糖治疗为口服药物，37.9%使用注射胰岛素，11.1%接受联合治疗。
结果
从医疗专业人员的角度来看，量表两个维度上个体化护理评分最高的方面与临床状况相关，提供方面的得分显著高于支持方面。患者在支持维度上评分最高的与临床状况和护理决策子量表相关；在护理提供维度上，护理中个体性最高的被归为护理决策子量表。在医疗专业人员和患者样本中，个体化护理评分最低的与个人生活状况子量表相关。
结论
医疗专业人员对老年糖尿病患者个体化护理的支持和提供方面比患者自身更为积极。患者特征，如降糖治疗类型、教育程度和营养状况，会影响患者对护理中个体性的理解和体验。
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