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患者对医疗保健决策中信息获取与决策制定的需求:自主偏好指数与健康意见调查。

Patient desire for information and decision making in health care decisions: the Autonomy Preference Index and the Health Opinion Survey.

作者信息

Nease R F, Brooks W B

机构信息

Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.

出版信息

J Gen Intern Med. 1995 Nov;10(11):593-600. doi: 10.1007/BF02602742.

Abstract

OBJECTIVES

To compare results on the Autonomy Preference Index (API) and the Health Opinion Survey (HOS), two instruments that measure patient desire for information and involvement in decision making.

DESIGN

Cross-sectional survey.

SETTING

University-based primary care outpatient longitudinal and acute care clinic.

PATIENTS

167 patients with benign prostatic hyperplasia, back pain, or mild hypertension seen from October 1991 to December 1992.

MEASUREMENTS AND MAIN RESULTS

On the API and the HOS (both scaled from 0 to 1), the patients had intermediate desire for involvement in decision making (median API: 0.42; HOS: 0.36) and higher desire for information (median API: 0.97; HOS: 0.57). With either instrument, the desire for information exceeded that for involvement in decision making (p < 0.0001). The API information scores were higher than the HOS information scores (p < 0.0001), probably because the HOS focuses on patient behavior rather than desire. Variation in desire for information and involvement in decision making was substantial and largely unexplained.

CONCLUSIONS

Most patients have a high desire for information, the desire for information and involvement in decision making varies substantially among patients, and the API is preferable to the HOS for researchers interested in focusing solely on patient desire for information.

摘要

目的

比较自主性偏好指数(API)和健康意见调查(HOS)的结果,这两种工具用于衡量患者对信息的需求以及参与决策的意愿。

设计

横断面调查。

地点

大学附属的基层医疗门诊纵向和急性病诊疗诊所。

患者

1991年10月至1992年12月期间就诊的167例良性前列腺增生、背痛或轻度高血压患者。

测量指标及主要结果

在API和HOS(两者评分范围均为0至1)上,患者参与决策的意愿处于中等水平(API中位数:0.42;HOS中位数:0.36),对信息的需求较高(API中位数:0.97;HOS中位数:0.57)。使用任何一种工具,对信息的需求均超过参与决策的意愿(p<0.0001)。API的信息得分高于HOS的信息得分(p<0.0001),可能是因为HOS关注的是患者行为而非需求。对信息的需求和参与决策的意愿差异很大,且很大程度上无法解释。

结论

大多数患者对信息有较高需求,患者对信息的需求和参与决策的意愿差异很大,对于仅关注患者对信息需求的研究人员而言API比HOS更适用。

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