Weiss S J
Soc Sci Med. 1986;22(4):489-96. doi: 10.1016/0277-9536(86)90053-5.
A stratified sample of 72 nurses, physicians and members of the general public met together in small tripartite dialogue groups each month for 20 months, in order to mutually identify health care behaviors that effectively involve patients in their own health care. Content analysis of 200 hours of verbatim transcripts from the dialogue sessions yielded 1245 patient involvement behaviors. These behaviors were rated by all subjects for their degree of importance within the normative health care relationship through use of a Likert-type inventory. Analysis of the 656 behaviors from the inventory which were classified as essential for effective patient involvement produced 44 clusters, with inter-item correlations ranging from 0.80 to 0.95. Further reduction of the 44 clusters indicated six core clusters, suggesting key norms that existed regarding effective involvement of patients in their own care. Salient norms centered on overt contracts in health relationships, egalitarian communication between patient and professional, patient access to broad-based information, tailoring of treatment programs, self-care and lifestyle modification. The lack of congruence between these norms and the realities of health care is discussed.
一个由72名护士、医生和普通民众组成的分层样本，每月以小型三方对话小组的形式相聚20个月，目的是共同确定能有效让患者参与自身医疗保健的行为。对对话环节200小时的逐字记录进行内容分析，得出了1245种患者参与行为。所有受试者通过使用李克特量表对这些行为在规范医疗关系中的重要程度进行了评分。对量表中被归类为有效患者参与必不可少的656种行为进行分析，产生了44个聚类，项目间的相关性在0.80至0.95之间。对这44个聚类的进一步简化表明有六个核心聚类，这表明在患者有效参与自身护理方面存在关键规范。突出的规范集中在健康关系中的公开契约、患者与专业人员之间的平等沟通、患者获取广泛信息、治疗方案的定制、自我护理和生活方式改变。讨论了这些规范与医疗保健现实之间的不一致之处。
