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患者参与骨科护理-髋关节手术患者对参与自身健康和医疗保健的偏好和体验的调查。

Patient participation in orthopaedic care-a survey on hip surgery patients' preferences for and experiences of engagement in their health and healthcare.

机构信息

Faculty of Medicine and Health Sciences, Department of Health, Medicine, and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden.

University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden; Department of Orthopaedics, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden.

出版信息

Int J Orthop Trauma Nurs. 2024 Aug;54:101118. doi: 10.1016/j.ijotn.2024.101118. Epub 2024 Jun 6.

Abstract

INTRODUCTION

Quality in health services is increasingly associated with enabling patients to participate in their own health and healthcare by recognising their resources and needs. Despite a growing recognition as to whether such participation is enabled, little is known regarding opportunities for preference-based patient participation in orthopaedic care.

AIMS

To investigate preference-based participation for patients in orthopaedic care due to hip surgery.

METHODS

Patients across 17 Swedish orthopaedic units who had had hip surgery, due to hip fracture or osteoarthritis, January-April 2021 were invited to complete the validated 4Ps questionnaire. Of 1514 patients, 458 patients returned the questionnaire with reports on their preferences for and experiences of participation. Each of the 4Ps' 12 items were analysed separately using descriptive and comparative statistics.

RESULTS

A complete match in preferences for, and experiences of, participation was achieved with variation between items for 41%-50% of the patients; if almost matches were included, this occurred for 57%-77% of the patients. Less participation than preferred was most common in terms of having had reciprocal communication, opportunities for partaking in planning, and in learning how to manage symptoms/issues. Hip fracture surgery was significantly associated with experiencing lower levels of participation than preferred.

CONCLUSION

Though standardised care promotes efficient hip surgery care, our study suggests a need for more person-centred opportunities to engage. A discrepancy was noted between patients' resources and preparation for their participation in and beyond the hip surgery process, particularly for self-care activities, calling for better use of nursing resources. ID: NCT04700969 with the U.S National Institutes of Health Clinical Registry.

摘要

简介

越来越多的人认为,通过识别患者的资源和需求,使患者能够参与到自身的健康和医疗保健中,这是医疗服务质量的关键。尽管人们越来越认识到这种参与是否可行,但对于患者在骨科护理中基于偏好的参与机会却知之甚少。

目的

研究髋关节手术后患者基于偏好的参与骨科护理的情况。

方法

2021 年 1 月至 4 月,邀请 17 家瑞典骨科病房的髋关节手术患者(因髋部骨折或骨关节炎)填写经过验证的 4Ps 问卷。在 1514 名患者中,有 458 名患者返回了问卷,报告了他们对参与的偏好和体验。使用描述性和比较性统计方法分别分析 4Ps 的 12 个项目。

结果

在偏好和体验方面完全匹配的患者比例为 41%-50%;如果包括几乎匹配的情况,那么这一比例为 57%-77%。与偏好相比,参与度较低的情况最常见于进行双向沟通、参与计划的机会以及学习如何管理症状/问题。髋部骨折手术与患者经历的参与度低于预期显著相关。

结论

尽管标准化护理促进了髋关节手术的高效护理,但我们的研究表明,需要更多以患者为中心的机会来参与。患者在参与和超越髋关节手术过程中的资源和准备情况存在差异,特别是在自我护理活动方面,这需要更好地利用护理资源。注册号:NCT04700969,由美国国立卫生研究院临床注册中心注册。

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