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以患者为中心的护理的认知和现状:对南佛罗里达州 Ryan White HIV 提供者的定性研究。

Perceptions and Current Practices in Patient-Centered Care: A Qualitative Study of Ryan White HIV Providers in South Florida.

机构信息

Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.

出版信息

J Int Assoc Provid AIDS Care. 2024 Jan-Dec;23:23259582241244684. doi: 10.1177/23259582241244684.

Abstract

Patient-centered care (PCC) improves HIV adherence and retention, though lack of consensus on its conceptualization and understanding how it is interpreted has hindered implementation. We recruited 20 HIV providers at Ryan White Programs in FL for in-depth interviews. Thematic analysis identified core consistencies pertaining to: 1) provider perceptions, 2) current practices promoting PCC. Provider perceptions of PCC emerged under four domains: 1) holistic, 2) individualized care, 3) respect for comfort and security, and 4) patient engagement and partnership. PCC practices occurred at multiple levels: 1) individual psychosocial and logistical support, 2) interpersonal support within patient-provider relationships through respectful communication and active engagement, and 3) institutional practices including feedback mechanisms, service integration, patient convenience, and diverse staffing. Our findings highlight the central tenets of PCC as respectful, holistic, individualized, and engaging care. We offer an HIV-adapted framework of PCC as a multilevel construct to guide future intervention.

摘要

以患者为中心的护理(PCC)可以提高 HIV 患者的治疗依从性和保留率,尽管其概念化方面缺乏共识,并且对于如何解释 PCC 存在理解上的差异,这阻碍了 PCC 的实施。我们在佛罗里达州的 Ryan White 项目中招募了 20 名 HIV 提供者进行深入访谈。主题分析确定了与以下四个方面相关的核心一致性:1)提供者的看法,2)当前促进 PCC 的实践。提供者对 PCC 的看法出现在四个领域:1)整体护理,2)个性化护理,3)尊重舒适度和安全性,4)患者参与和合作。PCC 实践发生在多个层面:1)个人心理社会和后勤支持,2)通过尊重的沟通和积极的参与在医患关系中建立人际支持,3)机构实践,包括反馈机制、服务整合、患者便利和多样化的人员配备。我们的研究结果强调了 PCC 的核心原则,即尊重、整体、个性化和有参与性的护理。我们提供了一个经过 HIV 调整的 PCC 框架,作为一个多层次的结构来指导未来的干预。

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Defining and implementing patient-centered care: An umbrella review.定义并实施以患者为中心的护理:一项综合综述。
Patient Educ Couns. 2022 Jul;105(7):1679-1688. doi: 10.1016/j.pec.2021.11.004. Epub 2021 Nov 16.

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