Suppr超能文献

患者、家庭成员和照护者参与制定加拿大三个省份基层医疗团队政策。

Patient, family member and caregiver engagement in shaping policy for primary health care teams in three Canadian Provinces.

机构信息

School of Nursing, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada.

School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.

出版信息

Health Expect. 2022 Aug;25(4):1730-1740. doi: 10.1111/hex.13516. Epub 2022 Jun 15.

Abstract

INTRODUCTION

Improving health services integration through primary health care (PHC) teams for patients with chronic conditions is essential to address their complex health needs and facilitate better health outcomes. The objective of this study was to explore if and how patients, family members, and caregivers were engaged or wanted to be engaged in developing, implementing and evaluating health policies related to PHC teams. This patient-oriented research was carried out in three provinces across Canada: British Columbia, Alberta and Ontario.

METHODS

A total of 29 semi-structured interviews with patients were conducted across the three provinces and data were analysed using thematic analysis.

RESULTS

Three key themes were identified: motivation for policy engagement, experiences with policy engagement and barriers to engagement in policy. The majority of participants in the study wanted to be engaged in policy processes and advocate for integrated care through PHC teams. Barriers to patient engagement in policy, such as lack of opportunities for engagement, power imbalances, tokenism, lack of accessibility of engagement opportunities and experiences of racism and discrimination were also identified.

CONCLUSION

This study increases the understanding of patient, family member, and caregiver engagement in policy related to PHC team integration and the barriers that currently exist in this engagement process. This information can be used to guide decision-makers on how to improve the delivery of integrated health services through PHC teams and enhance patient, family member, and caregiver engagement in PHC policy.

PATIENT OR PUBLIC CONTRIBUTION

We would like to acknowledge the contributions of our patient partners, Brenda Jagroop and Judy Birdsell, who assisted with developing and pilot testing the interview guide. Judy Birdsell also assisted with the preparation of this manuscript. This study also engaged patients, family members, and caregivers to share their experiences with engagement in PHC policy.

摘要

简介

通过初级卫生保健 (PHC) 团队改善慢性病患者的卫生服务整合对于满足他们复杂的健康需求和促进更好的健康结果至关重要。本研究的目的是探讨患者、家属和护理人员是否以及如何参与制定、实施和评估与 PHC 团队相关的卫生政策,以及他们希望如何参与。这项以患者为中心的研究在加拿大三个省份进行:不列颠哥伦比亚省、艾伯塔省和安大略省。

方法

在三个省份共进行了 29 次与患者的半结构式访谈,使用主题分析对数据进行分析。

结果

确定了三个关键主题:参与政策的动机、参与政策的经验和参与政策的障碍。研究中的大多数参与者希望参与政策制定过程,并通过 PHC 团队倡导整合护理。患者参与政策的障碍,如缺乏参与机会、权力失衡、象征性参与、参与机会的不可及性以及种族主义和歧视的经历也被确定。

结论

本研究增加了对患者、家属和护理人员参与与 PHC 团队整合相关政策以及当前参与过程中存在的障碍的理解。这些信息可以用于指导决策者如何通过 PHC 团队改善综合卫生服务的提供,并加强患者、家属和护理人员对 PHC 政策的参与。

患者或公众贡献

我们要感谢我们的患者合作伙伴 Brenda Jagroop 和 Judy Birdsell 的贡献,他们协助制定和试点测试访谈指南。Judy Birdsell 还协助准备了这份手稿。这项研究还让患者、家属和护理人员分享他们参与 PHC 政策的经验。

相似文献

2
Patient and caregiver perspectives on virtual care: a patient-oriented qualitative study.
CMAJ Open. 2022 Mar 1;10(1):E165-E172. doi: 10.9778/cmajo.20210065. Print 2022 Jan-Mar.
4
Facilitating Integration Through Team-Based Primary Healthcare: A Cross-Case Policy Analysis of Four Canadian Provinces.
Int J Integr Care. 2021 Nov 8;21(4):12. doi: 10.5334/ijic.5680. eCollection 2021 Oct-Dec.
5
Advancing team-based primary health care: a comparative analysis of policies in western Canada.
BMC Health Serv Res. 2017 Jul 17;17(1):493. doi: 10.1186/s12913-017-2439-1.
6
Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.
Int J Health Policy Manag. 2017 Nov 1;6(11):661-668. doi: 10.15171/ijhpm.2017.27.
9
Coordinating care for older adults in primary care settings: understanding the current context.
BMC Fam Pract. 2018 Aug 7;19(1):137. doi: 10.1186/s12875-018-0821-7.

本文引用的文献

1
Facilitating Integration Through Team-Based Primary Healthcare: A Cross-Case Policy Analysis of Four Canadian Provinces.
Int J Integr Care. 2021 Nov 8;21(4):12. doi: 10.5334/ijic.5680. eCollection 2021 Oct-Dec.
2
A Hierarchy of Power: The Place of Patient and Public Involvement in Healthcare Service Development.
Front Sociol. 2019 May 8;4:38. doi: 10.3389/fsoc.2019.00038. eCollection 2019.
4
Engaging indigenous patient partners in patient-oriented research: lessons from a one-year initiative.
Res Involv Engagem. 2020 Jul 22;6:44. doi: 10.1186/s40900-020-00216-3. eCollection 2020.
5
Thematic analysis of qualitative data: AMEE Guide No. 131.
Med Teach. 2020 Aug;42(8):846-854. doi: 10.1080/0142159X.2020.1755030. Epub 2020 May 1.
6
Patient engagement in the nonclinical setting: A concept analysis.
Nurs Forum. 2020 Jul;55(3):497-504. doi: 10.1111/nuf.12455. Epub 2020 Apr 23.
7
Comparing International Models of Integrated Care: How Can We Learn Across Borders?
Int J Integr Care. 2020 Apr 1;20(1):14. doi: 10.5334/ijic.5413.
8
Clarifying the degrees, modes, and muddles of "meaningful" patient engagement in health services planning and designing.
Patient Educ Couns. 2019 Sep;102(9):1581-1589. doi: 10.1016/j.pec.2019.04.006. Epub 2019 Apr 21.
9
The Leadership and Organizational Context Required to Support Patient Partnerships.
Healthc Q. 2018 Dec;21(SP):31-37. doi: 10.12927/hcq.2018.25641.
10
Using qualitative Health Research methods to improve patient and public involvement and engagement in research.
Res Involv Engagem. 2018 Dec 13;4:49. doi: 10.1186/s40900-018-0129-8. eCollection 2018.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验