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开发一种用于引出患者对以患者为中心的痴呆症护理阶段偏好的定量工具:一项形成性定性研究,旨在确定用于分析层次过程实验设计的患者相关标准。

Development of a Quantitative Instrument to Elicit Patient Preferences for Person-Centered Dementia Care Stage 1: A Formative Qualitative Study to Identify Patient Relevant Criteria for Experimental Design of an Analytic Hierarchy Process.

机构信息

German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany.

Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany.

出版信息

Int J Environ Res Public Health. 2022 Jun 22;19(13):7629. doi: 10.3390/ijerph19137629.

Abstract

Person-centered care (PCC) requires knowledge about patient preferences. This formative qualitative study aimed to identify (sub)criteria of PCC for the design of a quantitative, choice-based instrument to elicit patient preferences for person-centered dementia care. Interviews were conducted with = 2 dementia care managers, = 10 People living with Dementia (PlwD), and = 3 caregivers (CGs), which followed a semi-structured interview guide including a card game with PCC criteria identified from the literature. Criteria cards were shown to explore the PlwD's conception. PlwD were asked to rank the cards to identify patient-relevant criteria of PCC. Audios were verbatim-transcribed and analyzed with qualitative content analysis. Card game results were coded on a 10-point-scale, and sums and means for criteria were calculated. Six criteria with two sub-criteria emerged from the analysis; social relationships (indirect contact, direct contact), cognitive training (passive, active), organization of care (decentralized structures and no shared decision making, centralized structures and shared decision making), assistance with daily activities (professional, family member), characteristics of care professionals (empathy, education and work experience) and physical activities (alone, group). Dementia-sensitive wording and balance between comprehensibility vs. completeness of the (sub)criteria emerged as additional themes. Our formative study provides initial data about patient-relevant criteria of PCC to design a quantitative patient preference instrument. Future research may want to consider the balance between (sub)criteria comprehensibility vs. completeness.

摘要

以人为本的护理(PCC)需要了解患者的偏好。这项形成性定性研究旨在确定 PCC 的(子)标准,以设计一种基于选择的定量工具,以引出患者对以人为本的痴呆症护理的偏好。共对 2 名痴呆症护理经理、10 名与痴呆症共存的患者(PlwD)和 3 名护理人员(CG)进行了访谈,访谈遵循半结构化访谈指南,包括一个带有从文献中确定的 PCC 标准的纸牌游戏。展示标准卡以探索 PlwD 的概念。要求 PlwD 对卡片进行排名,以确定与患者相关的 PCC 标准。音频逐字转录,并使用定性内容分析进行分析。纸牌游戏结果以 10 分制进行编码,并计算标准的总和和平均值。分析得出了六个标准和两个子标准,分别是社会关系(间接接触、直接接触)、认知训练(被动、主动)、护理组织(分散结构和无共同决策、集中结构和共同决策)、日常活动协助(专业人员、家庭成员)、护理人员的特点(同理心、教育和工作经验)和体育活动(单独、团体)。痴呆症敏感措辞以及(子)标准的可理解性与完整性之间的平衡成为其他主题。我们的形成性研究提供了设计定量患者偏好工具的关于患者相关 PCC 标准的初步数据。未来的研究可能需要考虑(子)标准的可理解性与完整性之间的平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b806/9266267/5bf0b4780472/ijerph-19-07629-g001.jpg

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