在常规护理中实施哮喘治疗患者需求（NEAT）问卷：患者和卫生专业人员的定性研究。
Implementing the Patient Needs in Asthma Treatment (NEAT) questionnaire in routine care: a qualitative study among patients and health professionals.
机构信息
Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Institute of Social Medicine and Health Systems Research (ISMHSR), Medical Faculty, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
出版信息
BMC Pulm Med. 2023 Jan 17;23(1):21. doi: 10.1186/s12890-022-02293-4.
BACKGROUND
Many patients with asthma report unmet health care needs. The Patient Needs in Asthma Treatment (NEAT) questionnaire is a validated instrument to quantify these unmet needs. We explored how health professionals evaluated the instrument's utility as well as patients' and professionals' perspectives of how NEAT could be incorporated into routine clinical practice.
METHODS
Qualitative interviews were conducted by telephone between February and September 2021 with 19 patients with asthma and 21 health professionals (i.e., general practitioners, pneumologists, health professionals in pulmonary rehabilitation, and medical assistants). Interview recordings were transcribed verbatim and content-analyzed using both deductive and inductive approaches using MAXQDA.
RESULTS
Health professionals could see the potential value of using NEAT to inform clinical decisions. However, health professionals tended to be skeptical towards the routine use of NEAT in outpatient settings, mainly due to a lack of time. Implementation of NEAT was seen as more valuable in the context of patient education (i.e., in Disease Management Programs [DMPs] or pulmonary rehabilitation) by patients and health professionals alike, because it offered greater opportunities to address any unmet needs identified. Both patients and health professionals considered it more useful to use the questionnaire for the first time some time after the initial diagnosis has been made (e.g., when the treatment regime is found rather than at time of initial diagnosis). In the context of DMPs and pulmonary rehabilitation, NEAT could be used twice, i.e., before and after patient education to support patient-centered planning and evaluation.
CONCLUSION
Both patients and health professionals consider the use of the NEAT, in particular in educational programs (i.e., during DMPs or pulmonary rehabilitation), as feasible and useful. There is now a need to undertake a feasibility trial in routine care.
背景
许多哮喘患者报告存在未满足的医疗需求。患者哮喘治疗需求（NEAT）问卷是一种经过验证的工具，可以量化这些未满足的需求。我们探讨了卫生专业人员如何评估该工具的实用性，以及患者和专业人员对如何将 NEAT 纳入常规临床实践的看法。
方法
2021 年 2 月至 9 月期间，通过电话对 19 名哮喘患者和 21 名卫生专业人员（即全科医生、肺科医生、肺康复健康专业人员和医疗助理）进行了定性访谈。采访录音逐字转录，并使用 MAXQDA 采用演绎和归纳方法进行内容分析。
结果
卫生专业人员可以看到使用 NEAT 为临床决策提供信息的潜在价值。然而，卫生专业人员往往对在门诊环境中常规使用 NEAT 持怀疑态度，主要是因为缺乏时间。患者和卫生专业人员都认为，在患者教育（即疾病管理计划[DMP]或肺康复）的背景下，实施 NEAT 更有价值，因为它提供了更多机会来解决任何发现的未满足的需求。患者和卫生专业人员都认为，在初始诊断后一段时间（例如，在治疗方案确定后而不是在初始诊断时）首次使用该问卷更有用。在 DMP 和肺康复的背景下，可以两次使用 NEAT，即在患者教育之前和之后，以支持以患者为中心的计划和评估。
结论
患者和卫生专业人员都认为使用 NEAT（特别是在教育计划中，即在 DMP 或肺康复期间）是可行且有用的。现在需要在常规护理中进行可行性试验。
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