Eliciting Personhood Within Clinical Practice: Effects on Patients, Families, and Health Care Providers
Eliciting Personhood Within Clinical Practice: Effects on Patients, Families, and Health Care Providers
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DOI：
10.1016/j.jpainsymman.2014.11.291
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发表时间：
2015-06-01
影响因子：
4.7
通讯作者：
Harlos, Mike
中科院分区：
文献类型：
--
作者：
Chochinov, Harvey Max;McClement, Susan;Harlos, Mike
上下文不承认人格往往是病人和家属不满的原因。我们开发了患者尊严问题（PDQ），作为询问人格的一种简单方法：“我需要了解您的哪些方面，才能为您提供最好的护理？“目标。本研究旨在评估PDQ对患者和家庭的影响，评估其对医疗保健提供者（HCP）的影响，并确定HCP特征是否介导PDQ引发的信息的接受性。姑息治疗患者或其家属被要求回答PDQ。回答被总结，读给参与者，以确保准确性，并在允许的情况下，放在他们的图表。然后引出患者、家属和HCP对PDQ的反应。共有126名参与者（66名患者和60名家庭成员）对PDQ做出了回应; 99%的参与者表示总结准确，97%的参与者允许将总结放在图表中，93%的参与者认为HCP了解这些信息很重要，99%的参与者会向其他人推荐PDQ。共有137名HCP完成了293项个人PDQ的评估; 90%的人表示他们从中学到了一些新的东西，64%的人表示他们受到了情感上的影响，59%的人表示它影响了他们的同理心，44%的人表示它影响了他们的护理。HCP同理心、工作满意度、有意义的生活和社会支持介导了对PDQ引出信息的反应。PDQ提供了一种有效的方法来激发人格，增强患者，家庭和HCP的经验。(C)2015年美国临终关怀和姑息医学学会。爱思唯尔公司出版All rights reserved.
Context. Failure to acknowledge personhood is often the cause of patient and family dissatisfaction. We developed the Patient Dignity Question (PDQ) as a simple means of inquiring about personhood: "What do I need to know about you as a person to give you the best care possible?''Objectives. This study aimed to evaluate the impact of the PDQ on patients and families, evaluate its influence on health care providers (HCPs), and determine if HCP characteristics mediate receptivity to PDQ-elicited information.Methods. Palliative care patients or their family members were asked to respond to the PDQ. Responses were summarized, read to participants to ensure accuracy, and with permission, placed in their charts. Patient, family, and HCP responses to the PDQ were then elicited.Results. A total of 126 participants (66 patients and 60 family members) responded to the PDQ; 99% indicated that the summaries were accurate, 97% permitted the summary to be placed in the chart, 93% felt that the information was important for HCPs to know, and 99% would recommend the PDQ for others. A total of 137 HCPs completed 293 evaluations of individual PDQs; 90% indicated that they learned something new from it, 64% that they were emotionally affected by it, 59% that it influenced their sense of empathy, and 44% that it influenced their care. HCP empathy, job satisfaction, having a meaningful life, and social support mediated responsiveness to PDQ-elicited information.Conclusion. The PDQ offers an effective way of eliciting personhood, enhancing patient, family, and HCP experience alike. (C) 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.