What do patients and the public know about clinical practice guidelines and what do they want from them? A qualitative study.
What do patients and the public know about clinical practice guidelines and what do they want from them? A qualitative study.
复制标题
患者和公众对临床实践指南有何了解？他们想要什么？定性研究。
DOI：
10.1186/s12913-016-1319-4
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发表时间：
2016-02-24
影响因子：
2.8
通讯作者：
Treweek S
中科院分区：
文献类型：
--
作者：
Fearns N;Kelly J;Callaghan M;Graham K;Loudon K;Harbour R;Santesso N;McFarlane E;Thornton J;Treweek S
指南制作者越来越多地为公众制作指南版本。本研究的目的是探讨患者和公众对临床指南的目的和制作的理解，以及他们希望从临床指南中获得什么来支持他们的医疗保健决策。有目的地选择参与者，以代表一系列患者版本指南的可能用户，包括健康状况（糖尿病和抑郁症）的个人，公众，健康传播专业人员和一组年轻人。参与者被问及他们对临床指南的认识和理解，并向他们介绍了方案建议，或患者指南中的草稿材料，以促进讨论。每次讨论都由一名或两名研究人员主持。所有焦点小组在分析前都进行了记录和转录。使用框架分析对数据进行分析。我们进行了九个焦点小组，涉及62人，并辅以四次对无家可归者的采访。八个小组在苏格兰举行，一个在英格兰举行。这四次面试都是在苏格兰进行的。框架分析产生了五个主题：访问和意识;患者想知道什么;指南的属性;呈现证据;和格式。对指导方针的了解程度很低。与会者强调需要信息，使他们能够在治疗方案之间进行选择，包括危害。他们希望得到医疗保健专业人员的帮助，特别是全科医生。与会者对列入数字信息和图表的支持意见不一。公众需要信息来帮助他们选择治疗方法，包括有关危害的信息，特别是支持与卫生专业人员共同做出决定。呈现数字信息是一项挑战，分阶段呈现信息的分层方法可能会有所帮助。忽略本研究中确定的主题可能会导致材料无法支持公共和患者的医疗保健决策。本文的在线版本（doi：10.1186/s12913-016-1319-4）包含补充材料，可供授权用户使用。
Guideline producers are increasingly producing versions of guidelines for the public. The aim of this study was to explore what patients and the public understand about the purpose and production of clinical guidelines, and what they want from clinical guidelines to support their healthcare decisions. Participants were purposively selected to represent a range of the likely users of patient versions of guidelines, including individuals with health conditions (diabetes and depression), general members of the public, health communication professionals and a group of young people. Participants were asked about their awareness and understanding of clinical guidelines and presented with scenario recommendations, or draft materials from patient guidelines to prompt discussion. Each discussion was facilitated by one or two researchers. All focus groups were recorded and transcribed prior to analysis. Data were analysed using framework analysis. We ran nine focus groups involving 62 individuals, supplemented by four interviews with people experiencing homelessness. Eight groups were held in Scotland, one in England. The four interviews were held in Scotland. The framework analysis yielded five themes: access and awareness; what patients want to know; properties of guidelines; presenting evidence; and format. Awareness of guidelines was low. Participants emphasised the need for information that enables them to choose between treatment options, including harms. They would like help with this from healthcare professionals, especially general practitioners. Participants differed in their support for the inclusion of numerical information and graphs. Members of the public want information to help them choose between treatments, including information on harms, particularly to support shared decisions with health professionals. Presenting numerical information is a challenge and layered approaches that present information in stages may be helpful. Ignoring the themes identified in this study is likely to lead to materials that fail to support public and patient healthcare decision making. The online version of this article (doi:10.1186/s12913-016-1319-4) contains supplementary material, which is available to authorized users.