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评估干预措施以增加丹麦医疗保健环境中患者参与度的方法:快速综述。

Measures used to assess interventions for increasing patient involvement in Danish healthcare setting: a rapid review.

机构信息

Research Centre of Patient Involvement, Århus Universitetshospital, Aarhus, Denmark

Research Centre of Patient Involvement, Århus Universitetshospital, Aarhus, Denmark.

出版信息

BMJ Open. 2022 Dec 26;12(12):e064067. doi: 10.1136/bmjopen-2022-064067.

Abstract

OBJECTIVE

To identify measures used within Denmark evaluating any type of intervention designed to facilitate patient involvement in healthcare.

DESIGN

Environmental scan employing rapid review methods.

DATA SOURCES

MEDLINE, PsycInfo and CINAHL were searched from 6-9 April 2021 from database inception up to the date of the search.

ELIGIBILITY CRITERIA

Quantitative, observational and mixed methods studies with empirical data on outcomes used to assess any type of intervention aiming to increase patient involvement with their healthcare. Language limitations were Danish and English.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted data from 10% of the included studies and, due to their agreement, the data from the rest were extracted by first author. Data were analysed with reference to existing categories of measuring person-centred care; findings were synthesised using narrative summaries. Adapted Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines were used to guide reporting.

RESULTS

Among 3767 records, 43 studies met the inclusion criteria, including 74 different measures used to evaluate interventions aimed at increasing patient involvement within healthcare in Danish hospital and community settings. Generic measures assessed: patient engagement (n=3); supporting self-management (n=8); supporting shared decision-making (n=9); patient satisfaction and experiences of care (n=11); health-related patient-reported outcome (n=20).

CONCLUSIONS

Across Denmark, complex interventions designed to improve patient involvement with healthcare vary in their goals and content. Some targeting healthcare professionals, some patient health literacy and some service infrastructure. A plethora of measures assess the impact of these interventions on patient, professional and service delivery outcomes. Few measures assessed patient involvement directly, and it is unclear which proxy measures capture indicators of perceived involvement. Lack of conceptual clarity between intervention goals, the components of change and measures makes it difficult to see what types of intervention can best support change in services to ensure patients are more effectively involved in their healthcare.

摘要

目的

确定丹麦用于评估旨在促进患者参与医疗保健的任何类型干预措施的措施。

设计

采用快速审查方法进行环境扫描。

数据来源

2021 年 4 月 6 日至 9 日,从数据库创建到搜索日期,在 MEDLINE、PsycInfo 和 CINAHL 上进行了搜索。

入选标准

具有用于评估旨在增加患者对其医疗保健参与度的任何类型干预措施的结果的实证数据的定量、观察性和混合方法研究。语言限制为丹麦语和英语。

数据提取和综合

两名独立审查员从 10%的纳入研究中提取数据,由于他们的一致意见,由第一作者提取其余研究的数据。参考现有的人本关怀测量类别分析数据;使用叙述性摘要综合研究结果。使用改编的系统评价和荟萃分析的 Preferred Reporting Items 2020 指南来指导报告。

结果

在 3767 条记录中,有 43 项研究符合纳入标准,包括 74 种不同的措施,用于评估旨在提高丹麦医院和社区环境中医疗保健患者参与度的干预措施。通用措施评估:患者参与度(n=3);支持自我管理(n=8);支持共同决策(n=9);患者满意度和护理体验(n=11);与健康相关的患者报告结果(n=20)。

结论

在丹麦各地,旨在提高患者对医疗保健参与度的复杂干预措施在目标和内容上存在差异。一些针对医疗保健专业人员,一些针对患者健康素养,一些针对服务基础设施。大量措施评估这些干预措施对患者、专业人员和服务提供结果的影响。很少有措施直接评估患者的参与度,也不清楚哪些替代措施可以捕捉到参与感的指标。干预目标、变化的组成部分和措施之间缺乏概念上的一致性,使得难以确定哪种类型的干预措施最能支持服务的变革,以确保患者更有效地参与其医疗保健。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/9806071/7cdb117f516b/bmjopen-2022-064067f01.jpg

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