Meadows K A, Rogers D, Greene T
Department of Public Health and Primary Care Medicine, University of Hull.
Br J Gen Pract. 1998 Sep;48(434):1555-9.
Despite the increasing availability of multidimensional health status and outcome measures of the patient's physical and emotional functioning, and a number of national initiatives to promote their use, little is known about the attitudes and behaviour of general practitioners (GPs) and practice nurses (PNs) regarding their use in evaluating the effectiveness of health care. What evidence there is remains largely anecdotal but supports the view that health outcome data is currently not used in the routine management of the patient.
To investigate the attitudes and behaviour of GPs and PNs regarding the use of health outcome data in the routine care of patients with diabetes.
A questionnaire comprising 20 attitudinal and behavioural statements covering the use and benefits of health outcome data in the routine care of patients with diabetes were sent to 156 GPs and 114 PNs in the Doncaster area together with a covering letter and two examples of multidimensional health outcome measures.
Completed questionnaires were received from 90 (58%) GPs and 49 (50% corrected for out of scope) nurses. Median response scores showed that both GPs and nurses expressed a positive overall attitude towards health outcome measurement giving responses favourable to it in 15 (75%) and 18 (90%) of the statements respectively. A key finding was that 48% and 46% of GPs and PNs were unclear as to how they would use health outcome data.
While our findings reflect a favourable view towards the use of health outcome data for the routine management of the patient with diabetes in a general practice setting, a number of important barriers to their implementation have been identified. These include insufficient knowledge on their use, the need for easily interpretable data, and a lack of resources.
尽管患者身体和情感功能的多维健康状况及结局测量方法越来越容易获得,并且有多项国家倡议推动其使用,但对于全科医生(GP)和执业护士(PN)在使用这些测量方法评估医疗保健效果方面的态度和行为,我们知之甚少。现有的证据大多是传闻,但支持这样一种观点,即健康结局数据目前未用于患者的常规管理。
调查全科医生和执业护士在糖尿病患者常规护理中使用健康结局数据的态度和行为。
向唐卡斯特地区的156名全科医生和114名执业护士发送了一份问卷,其中包含20条关于健康结局数据在糖尿病患者常规护理中的使用及益处的态度和行为陈述,并附上一封附函以及两份多维健康结局测量方法的示例。
收到了90名(58%)全科医生和49名(经范围外校正后为50%)护士填写完整的问卷。中位数反应得分表明,全科医生和护士对健康结局测量总体上都持积极态度,分别在15条(75%)和18条(90%)陈述中给出了支持性的回答。一个关键发现是,48%的全科医生和46%的执业护士不清楚他们将如何使用健康结局数据。
虽然我们的研究结果反映了在全科医疗环境中对使用健康结局数据进行糖尿病患者常规管理的支持态度,但也发现了一些实施这些数据的重要障碍。这些障碍包括对其使用的知识不足、需要易于解读的数据以及缺乏资源。