患者决策偏好与感知参与护理:亚兹德教育医院个案研究

Mohamad Amin Bahrami, H. Jafari, S. Jambarsang, Samaneh Entezarian Ardakani
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摘要

背景:患者在决策过程中的偏好被定义为患者参与自我保健管理和决策的意愿。本研究的目的是评估2019年亚兹德选定的教育医院患者在决策程序和感知参与护理方面的偏好及其与人口统计学的关系。方法:对伊朗亚兹德市教学医院妇科、内科、外科住院患者195例进行研究。采用分层抽样方法选取住院患者。数据通过Degner和Sloan的控制偏好量表和Lerman等人的患者感知参与护理量表2份问卷收集,采用参数检验和非参数检验对数据进行分析。结果:总体而言,49.20%的患者在医疗决策过程中倾向于相对被动的角色,36.40%的患者在医疗决策中具有较高的参与意愿。不同类型患者的决策偏好在受教育程度、医院类型、住院病房类型、基本保险类型上差异有统计学意义(p≤0.05)。患者感知参与的平均得分为62.08±14.92。性别、疾病类型、医院类型、住院史、基本保险类型等因素对患者护理参与感知的平均得分差异有统计学意义(p < 0.05)。结论:在本研究中,很大比例的患者倾向于在决策中扮演相对被动的角色,因此卫生保健提供者最好向患者提供有关可用治疗方案及其相关收益/风险的可理解信息。此外,特别重要的是采取必要的干预措施,促进共同决策,特别是帮助女性患者和病情较急的患者,并支持保健提供者参与与患者共同决策的过程。
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Patients' Decision Making Preferences and Perceived Participation in Care: A Case Study in Selected Educational Hospitals of Yazd
Background: Patient's preferences in decision-making procedure are defined as the patient's willingness to participate in self-care management and decision-making. The aim of present study was to assess patients' preferences in decision-making procedure and perceived participation in care and their relationship with demographic in selected educational hospitals of Yazd in 2019. Methods: The study was conducted on 195 inpatients of the gynecology, internal medicine and surgery wards of teaching hospitals in Yazd of Iran. The inpatients were selected through stratified sampling method. The data was collected by 2 questionnaires: Degner and Sloan's control preferences scale and patients' perceived involvement in care scale of Lerman et al. parametric and non-parametric tests used to analyze the data. Results: In general, 49.20 % of patients preferred a relatively passive role in the decision-making process, and 36.40 % of them had high level of willingness to participate in their medical care decisions. The difference between the types of patients 'decision-making preferences was significant for education level, type of hospital and type of inpatient ward, type of basic insurance (p ≤ 0.05). The mean score of Patients' perceived participation was 62.08 ± 14.92. The difference observed in the mean score of patients' perceived participation in care for gender, type of disease, type of hospital, history of hospitalization, type of basic insurance was significant (p < 0.05). Conclusion: A large percentage of patients in the present study preferred a relatively passive role in decision-making, so it is best for health care providers to provide patients with understandable information about available treatment options and the benefits / risks associated with those choices. Also, the necessary interventions to promote shared decision-making, especially to help female patients and patients with more acute illnesses, as well as to support health care providers to participate in the shared decision-making process with patients, are of particular importance.
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