PATIENTS PARTICIPATION IN MEDICAL-CARE - EFFECTS ON BLOOD-SUGAR CONTROL AND QUALITY OF LIFE IN DIABETES
PATIENTS PARTICIPATION IN MEDICAL-CARE - EFFECTS ON BLOOD-SUGAR CONTROL AND QUALITY OF LIFE IN DIABETES
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DOI：
10.1007/bf02595921
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发表时间：
1988-09-01
影响因子：
5.7
通讯作者：
FRANK, HJL
中科院分区：
文献类型：
--
作者：
GREENFIELD, S;KAPLAN, SH;FRANK, HJL
为了最大限度地控制疾病，患者必须有效地参与医疗护理。作者开发了一种旨在增加患者参与医疗决策的干预措施。在常规访问医生之前的20分钟会议中，诊所助理在糖尿病算法的指导下与他/她一起审查了每个实验患者的医疗记录。通过系统提示，助理鼓励患者使用获得的信息与医生协商医疗决定。在两所大学医院的诊所进行了一项随机试验，将这种干预与标准教育材料进行比较。干预前平均糖化血红蛋白（HbA 1）值为10.6 ± 0.01。33例实验患者为2.1%，10.3 ±。2.0 26个对照。干预后，平均水平为9.1 ±。实验组为1.9%（p < 0.01），对照组为10.6 ± 0.01。对照组为2.22%。对医生访问录音带的分析表明，实验组患者从医生那里获得信息的效率是对照组的两倍。实验患者报告功能限制显著减少。作者得出结论，干预是可行的，它改变了患者的行为，改善了血糖控制，减少了功能限制。
To maximize disease control, patients must participate effectively in their medical care. The authors developed an intervention designed to increase the involvement of patients in medical decision making. In a 20-minute session just before the regular visit to a physician, a clinic assistant reviewed the medical record of each experimental patient with him/her, guided by a diabetes algorithm. Using systematic prompts, the assistant encouraged patients to use the information gained to negotiate medical decisions with the doctor. A randomized trial was conducted in two university hospital clinics to compare this intervention with standard educational materials is sessions of equal length. The mean pre-intervention glycosylated hemoglobin (HbA1) values were 10.6 .+-. 2.1% for 33 experimental patients and 10.3 .+-. 2.0 for 26 controls. After the intervention the mean levels were 9.1 .+-. 1.9% in the experimental group (p < 0.01) and 10.6 .+-. 2.22% for controls. Analysis of audiotapes of the visits to the physician showed the experimental patients were twice as effective as controls in eliciting information from the physician. Experimental patients reported significantly fewer function limitations. The authors conclude that the intervention is feasible and that it changes patient behavior, improves blood sugar control, and decreases functional limitations.