根据医疗保健专业人员的观点，与二级医疗保健中1型和2型糖尿病患者医疗决策相关的关键因素。

Key Factors Relevant for Healthcare Decisions of Patients with Type 1 and Type 2 Diabetes in Secondary Care According to Healthcare Professionals.

作者信息

Ruissen Merel M, Sont Jacob K, van Vugt Heidi A, Kunneman Marleen, Rutten Guy E H M, de Koning Eelco J P

机构信息

Department of Medicine, Leiden University Medical Centre, Leiden, the Netherlands.

Department of Biomedical Data Sciences, Section of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands.

出版信息

Patient Prefer Adherence. 2022 Mar 28;16:809-819. doi: 10.2147/PPA.S354686. eCollection 2022.

DOI:10.2147/PPA.S354686

PMID:35370405

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8974434/

Abstract

PURPOSE

Understanding which factors are important for healthcare decisions of patients with diabetes in clinical practice is important to personalise diabetes care strategies and tailor care plans to the individual. The main drivers for these healthcare decisions remain unclear. This study assessed which key factors are relevant for healthcare decisions during clinical consultations for patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM), according to healthcare professionals.

MATERIALS AND METHODS

Annual diabetes reviews were performed as part of a trial assessing the impact of a consultation model facilitating person-centred diabetes care in six hospital outpatient clinics. After each consultation, we asked healthcare professionals to choose a maximum of three out of 20 factors that were most relevant for healthcare decisions about treatment goals and the professional support needed during the upcoming year. Factors were characterised as either person or disease-related. Percentages reflect the number of annual diabetes reviews in which the key factor was reported.

RESULTS

Seventeen physicians and eight diabetes specialist nurses reported the key factors relevant for healthcare decisions in 285 annual diabetes reviews (T1DM n = 119, T2DM n = 166). Healthcare professionals most often reported quality of life (31.9%), motivation (27.0%) and diabetes self-management (25.6%), and to a lesser extent glycaemic control (24.2%), to be important for decisions about treatment goals. For decisions about the professional support needed during the upcoming year patient's preferences (33.7%), diabetes self-management (33.3%), quality of life (27.0%) and motivation (25.6%) were most often considered relevant by healthcare professionals.

CONCLUSION

According to healthcare professionals, person-related factors such as quality of life, diabetes self-management and motivation are predominantly relevant for healthcare decisions about treatment goals and the professional support needed during the upcoming year.

摘要

目的

了解在临床实践中哪些因素对糖尿病患者的医疗决策至关重要，对于个性化糖尿病护理策略和根据个体情况制定护理计划具有重要意义。这些医疗决策的主要驱动因素仍不明确。本研究根据医疗保健专业人员的看法，评估了哪些关键因素与1型糖尿病（T1DM）和2型糖尿病（T2DM）患者临床会诊期间的医疗决策相关。

材料与方法

作为一项试验的一部分，进行了年度糖尿病评估，该试验旨在评估一种促进以患者为中心的糖尿病护理的会诊模式在六家医院门诊诊所的影响。每次会诊后，我们要求医疗保健专业人员从20个因素中最多选择3个与未来一年治疗目标的医疗决策以及所需专业支持最相关的因素。这些因素被分为与个人或疾病相关。百分比反映了报告关键因素的年度糖尿病评估数量。

结果

17名医生和8名糖尿病专科护士在285次年度糖尿病评估（T1DM n = 119，T2DM n = 166）中报告了与医疗决策相关的关键因素。医疗保健专业人员最常报告生活质量（31.9%）、动机（27.0%）和糖尿病自我管理（25.6%），其次是血糖控制（24.2%），认为这些对治疗目标的决策很重要。对于未来一年所需专业支持的决策，医疗保健专业人员最常认为患者偏好（33.7%）、糖尿病自我管理（33.3%）、生活质量（27.0%）和动机（25.6%）相关。