患者的期望是什么?从患者角度评估以患者为中心:一项访谈研究。

What do patients expect? Assessing patient-centredness from the patients' perspective: an interview study.

机构信息

Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

出版信息

BMJ Open. 2021 Jul 12;11(7):e047810. doi: 10.1136/bmjopen-2020-047810.

Abstract

OBJECTIVE

Although there has been much conceptual work on patient-centredness (PC), patients' perspectives on PC were neglected. In a previous study, participating patients rated the relevance of 16 dimensions of an integrative model of PC as high to very high. However, it remained unclear which specific behaviours described in the dimensions were considered most relevant. Thus, the aim of the current study was to further explore which of the specific behaviours described in the model are especially relevant for the high ratings in the previous study.

METHODS AND DESIGN

We conducted semistructured interviews with 20 patients with chronic diseases (16 females, 4 males, mean age: 52 years). Patients answered questions regarding their experiences in the German healthcare system and how optimal healthcare would look like from their perspective. Furthermore, patients were asked to reflect on the most important aspects which they had mentioned in the interview before. Data were analysed via content analysis.

RESULTS

Participants addressed many different aspects of PC, but mostly focused on three major themes: (1) time appropriate access to care, (2) competence, empathy and being taken seriously by HCPs, (3) HCPs' individual consideration of each patient's situation (eg, wishes and needs). Minor themes were: (1) taking a holistic perspective of the patient, (2) patient-centred communication, (3) integration of multidisciplinary treatment elements, (4) transparency regarding waiting time and (5) reduction of unequal access to care.

CONCLUSION

This study enriches the construct of PC by depicting essential aspects of PC from the patients' perspective. The results allow prioritising strategies to implement patient-centred care. Thus, this study helps to pursue the ultimate goal of fostering patient-centred healthcare delivery in Germany.

摘要

目的

尽管已有大量关于以患者为中心(PC)的概念性工作,但患者对 PC 的看法却被忽视了。在之前的一项研究中,参与的患者对综合 PC 模型的 16 个维度的相关性评价很高,甚至非常高。然而,目前尚不清楚在这些维度中描述的哪些具体行为被认为是最相关的。因此,本研究的目的是进一步探讨模型中描述的哪些具体行为与之前研究中的高评分特别相关。

方法与设计

我们对 20 名患有慢性病的患者(16 名女性,4 名男性,平均年龄:52 岁)进行了半结构式访谈。患者回答了有关他们在德国医疗保健系统中的经验以及从他们的角度看最佳医疗保健的问题。此外,还要求患者反思他们在访谈中之前提到的最重要的方面。通过内容分析对数据进行分析。

结果

参与者提到了 PC 的许多不同方面,但主要集中在三个主要主题上:(1)适当时间获得医疗服务,(2)医疗保健提供者的能力、同理心和对患者的重视,(3)医疗保健提供者对每个患者情况的个人考虑(例如,愿望和需求)。次要主题是:(1)从整体角度看待患者,(2)以患者为中心的沟通,(3)整合多学科治疗元素,(4)关于等待时间的透明度,以及(5)减少医疗服务机会的不平等。

结论

本研究通过描绘患者视角下的 PC 的基本方面,丰富了 PC 的结构。研究结果允许优先考虑实施以患者为中心的护理的策略。因此,本研究有助于在德国追求促进以患者为中心的医疗保健服务的最终目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edaa/8276286/31c4f96ba1ad/bmjopen-2020-047810f01.jpg

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