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从患者和医疗保健专业人员的角度来看,患者参与患者安全的障碍和促进因素:系统评价和元综合。

Barriers and facilitators to patient engagement in patient safety from patients and healthcare professionals' perspectives: A systematic review and meta-synthesis.

机构信息

Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.

Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.

出版信息

Nurs Forum. 2021 Oct;56(4):938-949. doi: 10.1111/nuf.12635. Epub 2021 Aug 2.

DOI:10.1111/nuf.12635
PMID:34339525
Abstract

AIMS

To explore patients' and healthcare professionals' (HCPs) perceived barriers and facilitators to patient engagement in patient safety.

METHODS

We conducted a systematic review and meta-synthesis from five computerized databases, including PubMed/MEDLINE, Embase, Web of Science, Scopus and PsycINFO, as well as grey literature and reference lists of included studies. Data were last searched in December 2019 with no limitation on the year of publication. Qualitative and Mix-methods studies that explored HCPs' and patients' perceptions of barriers and facilitators to patient engagement in patient safety were included. Two authors independently screened the titles and the abstracts of studies. Next, the full texts of the screened studies were reviewed by two authors. Potential discrepancies were resolved by consensus with a third author. The Mixed Methods Appraisal Tool was used for quality appraisal. Thematic analysis was used to synthesize results.

RESULTS

Nineteen studies out of 2616 were included in this systematic review. Themes related to barriers included: patient unwillingness, HCPs' unwillingness, and inadequate infrastructures. Themes related to facilitators were: encouraging patients, sharing information with patients, establishing trustful relationship, establishing patient-centred care and improving organizational resources.

CONCLUSION

Patients have an active role in improving their safety. Strategies are required to address barriers that hinder or prevent patient engagement and create capacity and facilitate action.

摘要

目的

探讨患者和医疗保健专业人员(HCPs)在患者参与患者安全方面感知到的障碍和促进因素。

方法

我们从五个计算机数据库(包括 PubMed/MEDLINE、Embase、Web of Science、Scopus 和 PsycINFO)以及灰色文献和纳入研究的参考文献中进行了系统评价和元综合。数据最后一次搜索是在 2019 年 12 月,没有对发表年份进行限制。纳入了探索 HCPs 和患者对患者参与患者安全的障碍和促进因素的看法的定性和混合方法研究。两位作者独立筛选研究的标题和摘要。然后,两位作者审查了筛选研究的全文。潜在差异由第三位作者协商解决。使用混合方法评估工具进行质量评估。使用主题分析来综合结果。

结果

在 2616 篇研究中,有 19 篇研究被纳入本系统评价。与障碍相关的主题包括:患者不愿意、HCPs 不愿意和基础设施不足。与促进因素相关的主题包括:鼓励患者、与患者分享信息、建立信任关系、建立以患者为中心的护理和改善组织资源。

结论

患者在改善自身安全方面发挥着积极作用。需要采取策略来解决阻碍或阻止患者参与并创造能力和促进行动的障碍。

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