医疗保健专业人员对异基因造血干细胞移植背景下以患者为中心的护理的评分与看法
Healthcare Professionals' Ratings and Views of Person-Centred Care in the Context of Allogeneic Hematopoietic Stem Cell Transplantation.
作者信息
O'Sullivan Anna, Winterling Jeanette, Malmborg Kisch Annika, Bergkvist Karin, Edvardsson David, Wengström Yvonne, Lundh Hagelin Carina
机构信息
Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
Department of Nursing, Sophiahemmet University, Stockholm, Sweden.
出版信息
Health Serv Insights. 2025 Jan 2;18:11786329241310735. doi: 10.1177/11786329241310735. eCollection 2025.
INTRODUCTION
Allogeneic stem cell transplantation (allo-HCT) involves a long trajectory with high risk of complications. In person-centred care (PCC), patients' needs, resources and the care relationship are central to the care process. Healthcare professionals' (HCPs) ratings of PCC have not previously been investigated in this context.
OBJECTIVES
The aim of this study was to investigate healthcare professionals' ratings and views of person-centred care in allo-HCT care, and associations with individual characteristics and targeted PCC education.
DESIGN
Cross-sectional study, employing quantitative and qualitative methods.
METHODS
85 HCPs at two Swedish allo-HCT centres participated (80% women; mean age: 44 years, range: 23-72 years). A survey was conducted using the PCC Assessment Tool (P-CAT), containing 13 items, a total scale (min 13-max 65) and two subscales (I: min 8-max 40; II: min 5-max 25). Additionally, HCPs' written responses to four study-specific questions about PCC were collected.
RESULTS
The mean for P-CAT total scale was 45.31, (subscale I: 28.41; subscale II: 16.90). Higher ratings of PCC were reported for assessment of patients' needs, discussion about how to provide PCC and patients' care, while time to provide PCC, the care environment and how the organization prevents providing PCC were rated lower. Higher age and targeted PCC education were associated with higher PCC ratings. HCPs described PCC as the patient being seen as a capable individual with their own resources, with PCC increasing patient and family involvement-giving higher satisfaction and tailored care for patients. However, HCPs reported time as a barrier for PCC.
CONCLUSION
HCPs' ratings of PCC in this context are high regarding discussing and assessing patients' needs, but there is room for improvement regarding organizational and environmental aspects. Targeted PCC education increases the level of PCC. HCPs' views of PCC partly reflect the foundations of PCC-patient's narrative, capability and involvement.
引言
异基因干细胞移植（allo - HCT）过程漫长，并发症风险高。在以患者为中心的护理（PCC）中，患者需求、资源及护理关系是护理过程的核心。此前尚未在此背景下对医护人员（HCPs）对PCC的评级进行研究。
目的
本研究旨在调查医护人员对allo - HCT护理中以患者为中心护理的评级和看法，以及与个人特征和针对性PCC教育的关联。
设计
采用定量和定性方法的横断面研究。
方法
瑞典两个allo - HCT中心的85名医护人员参与（80%为女性；平均年龄：44岁，范围：23 - 72岁）。使用PCC评估工具（P - CAT）进行调查，该工具包含13个项目、一个总评分（最低13 - 最高65）和两个子量表（I：最低8 - 最高40；II：最低5 - 最高25）。此外，收集了医护人员对四个关于PCC的特定研究问题的书面答复。
结果
P - CAT总评分的平均值为45.31（子量表I：28.41；子量表II：16.90）。在评估患者需求、讨论如何提供PCC和患者护理方面，PCC的评级较高，而提供PCC的时间、护理环境以及组织如何防止提供PCC的评级较低。年龄较大和接受针对性PCC教育与较高的PCC评级相关。医护人员将PCC描述为将患者视为有自身资源的有能力个体，PCC增加了患者和家庭的参与度，从而为患者带来更高的满意度和个性化护理。然而，医护人员报告称时间是PCC的一个障碍。
结论
在此背景下，医护人员对PCC在讨论和评估患者需求方面的评级较高，但在组织和环境方面仍有改进空间。针对性的PCC教育提高了PCC水平。医护人员对PCC的看法部分反映了PCC的基础——患者的叙述、能力和参与度。
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