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患者在线获取全科医疗记录:一年随访后的感知效果。

Patient online access to medical records in general practice: Perceived effects after one year follow-up.

机构信息

Department of Health Promotion, Maastricht University, the Netherlands.

Department of Health Promotion, Maastricht University, the Netherlands.

出版信息

Patient Educ Couns. 2024 Aug;125:108309. doi: 10.1016/j.pec.2024.108309. Epub 2024 Apr 30.

Abstract

OBJECTIVE

Online access to medical records is expected to foster patient empowerment and patient-centred healthcare. However, data on actual experienced effects remain limited. We aimed to examine the development of effects patients perceive from online access.

METHODS

A nationwide online survey (N = 1769) evaluated Dutch patients' use of online access and beliefs about its effects on 16 outcomes at baseline and one-year follow-up. Analyses of Variance (ANOVA) were used to examine within-person belief changes across three user groups: patients who 1) used online access before the study, 2) started use during the study, and 3) did not use it at all.

RESULTS

There was a small decline in five beliefs around online access facilitating patient empowerment and participation in participants who started using online access during the study compared to at least one other user group. Most changes in beliefs did not differ between groups.

CONCLUSION

No evidence of benefits from online access was found. The findings might indicate inadequacies in the current system of online access. Possibly, the benefits of online access are contingent upon portal improvements and changes in documentation practices.

PRACTICE IMPLICATION

Records need to be easily accessible and comprehensible for patients. Consultation practices should enable patient participation.

摘要

目的

人们期望在线访问医疗记录能够增强患者的权能并提供以患者为中心的医疗服务。然而,关于实际体验到的效果的数据仍然有限。我们旨在研究患者从在线访问中感知到的效果的发展情况。

方法

一项全国范围的在线调查(N=1769)在基线和一年随访时评估了荷兰患者对在线访问的使用情况及其对 16 项结果的影响的看法。方差分析(ANOVA)用于检验三个用户组内的信念变化:1)在研究之前使用在线访问的患者,2)在研究期间开始使用的患者,以及 3)根本不使用的患者。

结果

与至少其他一个用户组相比,在研究期间开始使用在线访问的参与者中,有五项与在线访问促进患者赋权和参与相关的信念略有下降。大多数信念变化在组间没有差异。

结论

没有发现在线访问带来益处的证据。这些发现可能表明当前在线访问系统存在不足。可能需要在线访问门户改进和文档记录实践的改变才能带来益处。

实践意义

记录需要对患者来说易于访问且易于理解。咨询实践应能使患者参与其中。

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