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定制化患者治疗教育干预:以患者为中心的沟通模式。

Tailored patient therapeutic educational interventions: A patient-centred communication model.

机构信息

CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France.

Université de Reims Champagne-Ardenne, Reims, France.

出版信息

Health Expect. 2022 Feb;25(1):276-289. doi: 10.1111/hex.13377. Epub 2021 Nov 24.

Abstract

BACKGROUND

Tailoring therapeutic education consists of adapting the intervention to patients' needs with the expectation that this individualization will improve the results of the intervention. Communication is the basis for any individualization process. To our knowledge, there is no guide or structured advice to help healthcare providers (HCPs) tailor patient education interventions.

OBJECTIVES

We used a data-driven qualitative analysis to (1) investigate the reasons why HCPs tailor their educational interventions and (2) identify how this tailoring is effectively conducted. The perspective aimed to better understand how to individualize therapeutic patient education and to disentangle the different elements to set up studies to investigate the mechanisms and effects of individualization.

DESIGN

Individual semistructured interviews with 28 HCPs involved in patient education were conducted. The present study complied with the COREQ criteria.

RESULTS

Why individualization is necessary: participants outlined that the person must be thought of as unique and that therapeutic education should be adapted to the patient's personality and cognitive abilities. The first step in the individualization process was formalized by an initial patient assessment. Several informal practices were identified: if needed, giving an individual time or involving a specific professional; eliciting individual objectives; reinforcing the relationship by avoiding asymmetrical posture; focusing on patients' concerns; leading sessions in pairs; and making the patient the actor of decisions.

CONCLUSION

From our thematic data analysis, a model for tailoring patient education interventions based on the Haes and Bensing medical communication framework is proposed. The present work paves the way for evaluation, then generation of recommendations and finally implementation of training for individualization in educational interventions.

SHORT INFORMATIVE

Tailoring in therapeutic education consists of an adaptation to patients' needs. Communication is the basis for any individualization process. There is no model of patient-centred communication in educational interventions. From semistructured interviews with HCPs, we propose a patient-centred communication model for tailoring patient education intervention.

摘要

背景

定制化治疗教育包括根据患者需求调整干预措施,期望这种个性化能够改善干预效果。沟通是任何个性化过程的基础。据我们所知,目前还没有指导或结构化建议来帮助医疗保健提供者(HCP)定制患者教育干预措施。

目的

我们使用数据驱动的定性分析方法,(1)调查 HCP 定制其教育干预措施的原因,以及(2)确定如何有效地进行这种定制。这一视角旨在更好地理解如何对治疗性患者教育进行个性化,并厘清不同要素,以开展研究来探讨个性化的机制和效果。

设计

对 28 名参与患者教育的 HCP 进行了半结构化的个体访谈。本研究符合 COREQ 标准。

结果

为什么需要个性化:参与者概述说,人必须被视为独特的,治疗性教育应该适应患者的个性和认知能力。个性化过程的第一步是通过初始患者评估来规范化。还确定了几种非正式做法:如果需要,可以给予患者个人时间或涉及特定专业人员;明确个人目标;通过避免不对称的姿势来加强关系;关注患者的关注点;成对地引导会议;并让患者成为决策的主体。

结论

从我们的主题数据分析中,提出了一种基于 Haes 和 Bensing 医学沟通框架的定制患者教育干预措施的模型。本工作为评估、制定建议以及实施教育干预中的个性化培训铺平了道路。

简要信息

治疗教育中的定制化是指对患者需求的调整。沟通是任何个性化过程的基础。教育干预中没有以患者为中心的沟通模型。通过对 HCP 的半结构化访谈,我们提出了一个以患者为中心的沟通模型,用于定制患者教育干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eac4/8849242/205b0e179e46/HEX-25-276-g001.jpg

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