Patients', carers' and healthcare providers' views of patient-held health records in Kerala, India: A qualitative exploratory study.
Patients', carers' and healthcare providers' views of patient-held health records in Kerala, India: A qualitative exploratory study.
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DOI：
10.1111/hex.13721
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发表时间：
2023-06
影响因子：
3.2
通讯作者：
Lavis, Anna
中科院分区：
文献类型：
--
作者：
Joseph, Linju;Greenfield, Sheila;Manaseki-Holland, Semira;Lekha, T. R.;Sujakumari, S.;Panniyammakal, Jeemon;Lavis, Anna
医疗就诊和医疗服务提供者之间的医疗信息传输不畅对患者安全构成潜在威胁。患者持有的健康记录（PHR）可用于促进信息连续性、移交沟通和患者自我管理。然而，除了在妇幼保健方面之外，关于医生促进人权的有效性，存在着相互矛盾的意见。此外，低收入和中等收入国家的医生促进健康报告使用者的经验对政策决定至关重要，但很少得到研究。本研究旨在探讨喀拉拉邦目前糖尿病和高血压的PHR的患者，护理人员和医疗保健提供者（HCP）的观点的相似性和差异。采用定性设计，包括半结构化访谈与糖尿病/高血压患者（n = 20），照顾者（n = 15）和HCP（n = 17）在喀拉拉邦，印度。采用专题分析法对数据进行了分析。比较和对比了每个用户组关于PHR经验的主题。所产生的主题分为三个标题：在日常实践中使用促进健康和生殖健康的建议;促进健康和生殖健康的建议的价值观以及实践和价值观发生冲突的地方。我们发现，在日常实践中使用PHR时，多个PHR给携带记录的患者和查找相关信息的HCP带来了挑战。大多数护理人员携带所有患者过去的PHR，而患者根据医疗保健访问的目的决定沿着携带哪个PHR。HCP赞赏PHR，但其中记录的细节有限。各组对自身的PHRs感知价值不同。虽然HCP重视PHR以实现更好的临床决策，防止错误和患者安全，但患者将其视为糖尿病和高血压药物的交易工具;护理人员强调了其在紧急情况下的价值。我们的研究结果表明，用户发现各种价值的PHR。然而，这些感知值对于每个用户组是不同的，这表明PHR用于信息连续性、切换通信和自我管理的功能最小。患者和护理人员参与了主题指南、同意书和研究信息表的试点测试。患者和护理人员对材料提供了反馈，以确保在上下文中的清晰度和适当性。
Poor medical information transfer across healthcare visits and providers poses a potential threat to patient safety. Patient‐held health records (PHRs) may be used to facilitate informational continuity, handover communication and patient self‐management. However, there are conflicting opinions on the effectiveness of PHRs, other than in maternal and child care. Moreover, the experiences of users of PHRs in low‐ and middle‐income countries are critical in policy decisions but have rarely been researched. This study aimed to explore similarities and differences in the perspectives of patients, carers and healthcare providers (HCPs) on the current PHRs for diabetes and hypertension in Kerala. A qualitative design was used comprising semistructured interviews with patients with diabetes/hypertension (n = 20), carers (n = 15) and HCPs (n = 17) in Kerala, India. Data were analysed using thematic analysis. Themes generated regarding the experiences with PHRs from each user group were compared and contrasted. The themes that arose were organized under three headings: use of PHRs in everyday practice; the perceived value of PHR and where practice and value conflict. We found that in the use of PHRs in everyday practice, multiple PHRs posed challenges for patients carrying records and for HCPs locating relevant information. Most carers carried all patients' past PHRs, while patients made decisions on which PHR to take along based on the purpose of the healthcare visit. HCPs appreciated having PHRs but documented limited details in them. The perceived value of PHRs by each group for themselves was different. While HCPs placed value on PHRs for enabling better clinical decision‐making, preventing errors and patient safety, patients perceived them as transactional tools for diabetes and hypertension medications; carers highlighted their value during emergencies. Our findings suggest that users find a variety of values for PHRs. However, these perceived values are different for each user group, suggesting minimal functioning of PHRs for informational continuity, handover communication and self‐management. Patients and carers were involved during the pilot testing of topic guides, consent and study information sheets. Patients and carers gave their feedback on the materials to ensure clarity and appropriateness within the context.
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影响因子：
5.4
作者：
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