Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Patient Educ Couns. 2024 Aug;125:108298. doi: 10.1016/j.pec.2024.108298. Epub 2024 Apr 25.
Explore factors influencing patient comfort with and perceived helpfulness of screening for health-related social needs.
In a parallel secondary mixed-methods analysis of data from three primary care clinics, we used logistic regression to examine effects of practice- and patient-level factors on comfort with and perceived helpfulness of social needs screening. We applied narrative analysis to 20 patient interviews to further understand how patients' lived experiences influenced their perceptions of screening.
Among 511 patients, receiving an explanation about screening was associated with increased odds of comfort (OR 2.1, 95% CI [1.1-4.30]) and perceived helpfulness (OR 4.7 [2.8-7.8]). Those experiencing more needs were less likely to report comfort (3 + needs vs. 0: OR 0.2 [0.1-0.5]). Narratives elucidated how a history of stigmatizing experiences increased discomfort disclosing needs and captured how relationship quality with healthcare teams influenced perceptions of screening for patients with extensive needs.
Practice-level (screening explanation and therapeutic rapport) and patient-level factors (history and extent of needs) are key influences on comfort with and perceived helpfulness of screening.
Good communication about screening benefits all patients. Patients with extensive social needs may require additional sensitivity to their past experiences.
探讨影响患者对健康相关社会需求筛查的舒适度和感知有用性的因素。
在对来自三家初级保健诊所的资料进行平行的二级混合方法分析中，我们使用逻辑回归来检查实践和患者层面因素对社会需求筛查的舒适度和感知有用性的影响。我们对 20 名患者的访谈进行了叙述性分析，以进一步了解患者的生活经历如何影响他们对筛查的看法。
在 511 名患者中，接受有关筛查的解释与增加舒适度的几率（比值比[OR]2.1，95%置信区间[CI]为[1.1-4.30]）和感知有用性（OR 4.7[2.8-7.8]）相关。那些经历更多需求的人报告舒适度的可能性较低（3+需求与 0 相比：OR 0.2[0.1-0.5]）。叙述阐明了过去有污名化经历如何增加披露需求的不适，并捕捉了与医疗保健团队的关系质量如何影响对有广泛需求的患者进行筛查的看法。
实践层面（筛查解释和治疗融洽关系）和患者层面因素（需求的历史和程度）是影响舒适度和感知有用性的关键因素。
有关筛查的良好沟通对所有患者都有益。有广泛社会需求的患者可能需要对他们的过去经历更加敏感。
