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让患者和照护者参与初级保健中的患者安全:一项针对共同设计的患者安全指南的定性研究。

Involving patients and carers in patient safety in primary care: A qualitative study of a co-designed patient safety guide.

机构信息

NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care and Health Services Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.

出版信息

Health Expect. 2023 Apr;26(2):630-639. doi: 10.1111/hex.13673. Epub 2023 Jan 16.

Abstract

BACKGROUND

Involving patients is a key premise of national and international policies on patient safety, which requires understanding how patients or carers want to be involved and developing resources to support this. This paper examines patients' and carers' views of being involved in patient safety in primary care and their views of potentially using a co-designed patient safety guide for primary care (PSG-PC) to foster both involvement and their safety.

METHODS

A qualitative study using semistructured face-to-face interviews with 18 patients and/or carers in primary care. Interviews were transcribed and analysis was conducted using an inductive thematic approach.

RESULTS

Overall participants expressed enthusiasm for the PSG-PC as a tool to support patients and carers to be involved in patient safety in primary care. However, for some participants being involved in patient safety was seen as taking on the role of General Practitioner and had the potential to add an additional workload for patients. Participants' willingness or ability to be involved in patient safety was influenced by a range of factors including an invisible, often underacknowledged role of everyday safety for patients' interactions with primary care; the levels of involvement that patients wanted in their care and safety and the work of embedding the PSG-PC for patients into their routine interactions with primary care. Participants identified components of the PSG-PC that would be useful to them, in particular, if they had a responsibility for caring for a family member if they had more complex care or long-term conditions.

CONCLUSION

Involving patients and carers in patient safety needs a tailored and personalized approach that enables patients and carers to use resources like the PSG-PC routinely and helps challenge assumptions about their willingness and ability to be involved in patient safety. Doing so would raise awareness of opportunities to be involved in safety in line with personal preference.

PATIENT OR PUBLIC CONTRIBUTION

Patient and public involvement were central to the research study. This included working in partnership to develop the PSG-PC with patients and carers and throughout our study including in the design of the study, recruiting participants, interpretation of findings.

摘要

背景

让患者参与是国家和国际患者安全政策的关键前提,这需要了解患者或护理人员希望如何参与,并开发资源来支持这一点。本文研究了患者和护理人员在初级保健中参与患者安全的观点,以及他们对使用共同设计的初级保健患者安全指南(PSG-PC)来促进参与和安全的看法。

方法

采用半结构化面对面访谈的方法,对初级保健中的 18 名患者和/或护理人员进行了定性研究。对访谈进行了转录,并采用归纳主题方法进行了分析。

结果

总体而言,参与者对 PSG-PC 作为支持患者和护理人员参与初级保健患者安全的工具表示热情。然而,对于一些参与者来说,参与患者安全被视为承担全科医生的角色,并且有可能给患者增加额外的工作量。参与者参与患者安全的意愿或能力受到多种因素的影响,包括患者与初级保健互动中日常安全的无形、往往未被充分认识的角色;患者希望在其护理和安全方面的参与程度以及将 PSG-PC 嵌入患者与初级保健的日常互动中的工作。参与者确定了 PSG-PC 对他们有用的组件,特别是如果他们有照顾家庭成员的责任,如果他们有更复杂的护理或长期疾病。

结论

让患者和护理人员参与患者安全需要采取量身定制和个性化的方法,使患者和护理人员能够常规使用 PSG-PC 等资源,并有助于挑战他们参与患者安全的意愿和能力的假设。这样做将提高对参与安全的机会的认识,符合个人偏好。

患者或公众的贡献

患者和公众的参与是研究的核心。这包括与患者和护理人员合作共同开发 PSG-PC,并在我们的研究中包括在研究设计、参与者招募、结果解释中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0629/10010084/b614827df7c2/HEX-26--g001.jpg

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