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在两所大型大学医院中对以患者为中心的护理的看法:一项针对医护专业人员的横断面调查。

Perceptions of person-centred care in two large university hospitals: A cross-sectional survey among healthcare professionals.

机构信息

Department of Psychology, University of Southern Denmark, Odense, Denmark.

Research Support Unit, University Hospital Zealand, Roskilde, Denmark.

出版信息

Scand J Caring Sci. 2022 Sep;36(3):791-802. doi: 10.1111/scs.13014. Epub 2021 Jul 1.

Abstract

BACKGROUND

Patient-centred care (PCC) including collaborative practices is the core component of modern health care. Despite this, it has proven difficult to implement.

AIMS

To examine (1) healthcare professionals' (HCPs') perception of whether they perceive a PCC culture, their attitudes towards involving patients in decisions and their experiences of barriers for PCC; and (2) variables that may contribute to explain differences in perceived person-centred culture.

METHODS

A questionnaire survey of HCPs from 27 different departments from two university hospitals in Denmark. HCPs were eligible if they held a profession as physician, Registered Nurse, nurse assistant, physiotherapist, occupational therapist, dietician, midwife or psychologist and excluded if they reported not being involved in patient treatment and care. The questionnaire consisted of four items from the Context Assessment Index (CAI). The remaining items were purpose-designed.

RESULTS

In total 1140 (24% response rate) HCPs completed the questionnaire and were included in the analyses. Most of the HCPs perceived a culture of PCC (e.g. 91% agreed or agreed to a high degree that patients were provided with opportunities to participate in decisions). Most HCPs also held positive attitudes towards involving patients in decisions. Time and prioritisation from the management were perceived as barriers for PCC, and many HCPs also believed that involving patients in decisions could be difficult for the patients. The HCPs who were least involved in treatment and care, and working in the acute setting or in surgery, were least likely to perceive a PCC culture. HCPs with the longest or shortest educations, and HCPs working primarily with outpatients or with planned inpatients, were most likely to perceive a person-centred culture.

CONCLUSION

The HCPs generally perceived a culture of PCC and held positive attitudes towards involving patients in decisions. To further promote PCC, time and prioritisation must be invested at an organisational level.

摘要

背景

以患者为中心的护理(PCC)包括协作实践是现代医疗保健的核心组成部分。尽管如此,实施起来却颇具难度。

目的

(1)考察医护人员对 PCC 文化的看法,他们对让患者参与决策的态度以及 PCC 面临的障碍的体验;(2)研究可能有助于解释感知的以患者为中心的文化差异的变量。

方法

对丹麦两所大学医院 27 个不同科室的医护人员进行问卷调查。合格的医护人员为执业医师、注册护士、护士助理、物理治疗师、职业治疗师、营养师、助产士或心理学家,排除那些报告未参与患者治疗和护理的医护人员。问卷包括四个来自语境评估指数(CAI)的项目。其余项目是专门设计的。

结果

共有 1140 名(24%的回应率)医护人员完成了问卷并纳入分析。大多数医护人员认为存在 PCC 文化(例如,91%的人同意或非常同意患者有机会参与决策)。大多数医护人员对让患者参与决策也持有积极态度。时间和管理层的优先级被视为 PCC 的障碍,许多医护人员还认为让患者参与决策可能对患者来说有难度。参与治疗和护理最少、在急症室或外科工作的医护人员最不可能感知到 PCC 文化。接受教育时间最长或最短的医护人员,以及主要治疗门诊患者或计划住院患者的医护人员,最有可能感知到以患者为中心的文化。

结论

医护人员普遍认为存在 PCC 文化,并对让患者参与决策持有积极态度。为了进一步促进 PCC,必须在组织层面投入时间和优先级。

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