Department of Ethics, Law, and Humanities, Faculty of Medicine, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
Department of Medical Education and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
BMC Health Serv Res. 2023 Apr 25;23(1):400. doi: 10.1186/s12913-023-09394-8.
Accessible and high-quality primary health care (PHC) is fundamental to countries moving towards universal health coverage. In order to improve the quality of patient-centered care provided in PHC, a comprehensive understanding of patients' values is crucial to address any gaps in the health care system. This systematic review aimed to identify patients' values relevant to PHC.
We searched primary qualitative and quantitative studies about patients' values related to primary care in PubMed and EMBASE (Ovid) from 2009 to 2020. The studies' quality was assessed using Joanna Briggs Institute (JBI) Critical Appraisal Checklist for both quantitative and qualitative studies and Consolidated Criteria for Reporting Qualitative Studies (COREQ) for qualitative studies. A thematic approach was used in the data synthesis.
The database search resulted in 1,817 articles. A total of 68 articles were full-text screened. Data were extracted from nine quantitative and nine qualitative studies that met the inclusion criteria. The participants of the studies were mainly the general population in high-income countries. Four themes emerged from the analysis: patients' values related to privacy and autonomy; values associated with the general practitioners including virtuous characteristics, knowledge and competence; values involving patient-doctor interactions such as shared decision-making and empowerment; and core values related to the primary care system such as continuity, referral, and accessibility.
This review reveals that the doctor's personal characteristics and their interactions with the patients are critical considerations concerning the primary care services from the patients' point of view. The inclusion of these values is essential to improve the quality of primary care.
可及且高质量的初级卫生保健（PHC）是各国实现全民健康覆盖的基础。为了提高 PHC 中以患者为中心的护理质量，全面了解患者的价值观对于解决医疗体系中的任何差距至关重要。本系统评价旨在确定与 PHC 相关的患者价值观。
我们在 PubMed 和 EMBASE（Ovid）中搜索了 2009 年至 2020 年与初级保健相关的患者价值观的原始定性和定量研究。使用 Joanna Briggs 研究所（JBI）的定量和定性研究的批判性评估清单以及定性研究的统一报告标准（COREQ）评估研究质量。在数据综合中使用了主题方法。
数据库搜索产生了 1817 篇文章。共有 68 篇文章进行了全文筛选。从符合纳入标准的九项定量研究和九项定性研究中提取了数据。研究的参与者主要是高收入国家的一般人群。分析得出了四个主题：患者与隐私和自主权相关的价值观；与全科医生相关的价值观，包括美德特征、知识和能力；涉及医患互动的价值观，如共同决策和赋权；以及与初级保健系统相关的核心价值观，如连续性、转诊和可及性。
本综述表明，从患者的角度来看，医生的个人特征及其与患者的互动是初级保健服务的关键考虑因素。纳入这些价值观对于提高初级保健质量至关重要。
