The different perspectives of patients, informal caregivers and professionals on patient involvement in primary care teams. A qualitative study
The different perspectives of patients, informal caregivers and professionals on patient involvement in primary care teams. A qualitative study
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DOI：
10.1111/hex.12824
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发表时间：
2018-12-01
影响因子：
3.2
通讯作者：
Paauwe, Jaap
中科院分区：
文献类型：
--
作者：
Doekhie, Kirti D.;Strating, Mathilde M. H.;Paauwe, Jaap
背景：患者参与决策过程，尤其是慢性病老年患者的参与，在包括荷兰在内的许多国家已成为以患者为中心的初级医疗的一个重要要素。本研究公开探讨了患者、非正式照顾者以及初级医疗专业人员对于患者参与初级医疗团队互动的不同观点。
方法：对慢性病老年患者、非正式照顾者以及来自不同学科的初级医疗专业人员进行了64次定性半结构化访谈。本研究以现象学方法为基础，采用常规内容分析法进行数据分析。
结果：参与者对患者和非正式照顾者在初级医疗团队中的角色有不同看法，因此对患者参与的程度和水平也有不同期望。三个挑战影响患者在团队中的参与：（a）当专业人员掌控局面时，患者感到被误解且参与程度未达自身期望；（b）患者必须平衡不同专业人员相互冲突的意见；（c）由于非正式照顾者自身对患者参与程度的看法，他们可能会不适当地充当团队领导者。
讨论与结论：患者参与是在患者、非正式照顾者以及多个专业人员之间复杂的互动中形成的，他们的观点和期望可能不一致。认识到患者和非正式照顾者在团队中的价值有助于专业人员更好地理解他们，从而减少团队互动中出现挑战的可能性。
Background: Patient involvement in the decision-making process, especially for chronically ill elderly patients, has become an important element of patient-centred primary care in many countries, including the Netherlands. This study openly explores different perspectives of patients, informal caregivers and primary care professionals on patient involvement in primary care team interactions.Methods: Sixty-four qualitative semi-structured interviews with chronically ill elderly patients, informal caregivers and primary care professionals from various disciplines. Underpinned by a phenomenology approach, this study used conventional content analysis for data analysis.Results: Participants have different views of the roles of patients and informal caregivers in the primary care team and thus different expectations of the extent and level of patient involvement. Three challenges impact patient involvement in the team: (a) patients feel misunderstood and less involved that they would like when professionals take control, (b) patients have to balance the conflicting opinions of different professionals and (c) informal caregivers act undesirably as team leaders due to their own view of the level of patient involvement.Discussion and conclusion: Patient involvement is formed in complex interactions between patients, informal caregivers and multiple professionals whose perspectives and expectations can be misaligned. Recognizing the value of patients and informal caregivers on the team could help professionals to understand them better and thus limit the likelihood of challenges arising in team interactions.