Landgren Ellen, Bremander Ann, Lindqvist Elisabet, Nylander Maria, Larsson Ingrid
Lund University and Skåne University Hospital, Lund, Sweden.
Spenshult Research and Development Centre, Halmstad, Sweden.
ACR Open Rheumatol. 2021 Nov;3(11):788-795. doi: 10.1002/acr2.11326. Epub 2021 Aug 17.
Most research on patient experiences of rheumatoid arthritis (RA) care is performed with patients who have established RA and less often with patients with early RA. Experiences of and expectations about health care may change over time, which is why the aim was to explore patients' perceptions of person-centered care (PCC) early in the RA disease course.
Thirty-one patients with early RA were interviewed in this qualitative study. An abductive qualitative content analysis was conducted based on the framework of McCormack and McCance (1,2). The four constructs, prerequisites, care environment, person-centered processes, and person-centered outcomes, constituted the four categories in the deductive part of the study. An inductive analysis generated 11 subcategories exploring the content of PCC.
For patients with early RA, PCC was described in terms of 1) prerequisites including being treated with respect, meeting dedicated health care professionals, and meeting professional competence; 2) care environment including having access to a multidisciplinary team, having access to health care, and encountering a supportive organization; 3) person-centered processes including being listened to, being supported, and being involved in decision-making; and 4) person-centered outcomes including being satisfied with received health care and achieving optimal health.
Genuine PCC is important for patients early in the RA disease course, supporting the implementation of a person-centered approach during all stages in the health care system. This study contributes to information about how to further develop person-centeredness in rheumatology care.
大多数关于类风湿关节炎(RA)护理患者体验的研究是针对已确诊RA的患者进行的,而针对早期RA患者的研究较少。对医疗保健的体验和期望可能会随时间而变化,这就是为什么本研究旨在探讨患者在RA病程早期对以患者为中心的护理(PCC)的认知。
在这项定性研究中,对31名早期RA患者进行了访谈。基于麦科马克和麦坎斯的框架(1,2)进行了归纳性定性内容分析。四个构建要素,即先决条件、护理环境、以患者为中心的过程和以患者为中心的结果,构成了研究演绎部分的四个类别。归纳分析产生了11个子类别,用于探索PCC的内容。
对于早期RA患者,PCC体现在以下方面:1)先决条件,包括受到尊重的对待、遇到专业的医疗保健人员以及具备专业能力;2)护理环境,包括能够获得多学科团队的服务、能够获得医疗保健以及遇到支持性的组织;3)以患者为中心的过程,包括被倾听、得到支持以及参与决策;4)以患者为中心的结果,包括对所接受的医疗保健感到满意以及实现最佳健康状态。
真正的PCC对RA病程早期的患者很重要,这支持在医疗保健系统的所有阶段实施以患者为中心的方法。本研究有助于提供有关如何在风湿病护理中进一步发展以患者为中心理念的信息。