A tool to strengthen the older patient-companion partnership in primary care: results from a pilot study.
A tool to strengthen the older patient-companion partnership in primary care: results from a pilot study.
复制标题
加强初级保健中老年患者与同伴伙伴关系的工具：试点研究的结果。
DOI：
10.1111/jgs.12639
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发表时间：
2014
影响因子：
6.3
通讯作者：
Gitlin,LauraN
中科院分区：
文献类型：
--
作者：
Wolff,JenniferL;Roter,DebraL;Barron,Jeremy;Boyd,CynthiaM;Leff,Bruce;Finucane,ThomasE;Gallo,JosephJ;Rabins,PeterV;Roth,DavidL;Gitlin,LauraN
ObjectiveTo determine a pre-consultation checklist for elderly adults who attend medical visits with an unpaid companies and to evaluate its effects on visit communication.DesignRandomized controlled pilot study.SettingAcademic geriatrics ambulatory clinic. ChampantsThirteen ‐ 2 individuals aged 65 and older and their unpaid companies.InterventionA self-administered checklist was compared with usual care.检查表的目的是引出和调整病人和伴侣的观点，对健康问题进行讨论，与医生和刺激讨论伴侣的作用在visit.MeasurementPrimary结局：以病人为中心的沟通，从访问录音带编码的比率。次要结局：检查表的可接受性;访问时间;患者同伴语言活动; patient‐ and physician‐reported perspectives of the visit.ResultsAll干预患者和同伴（n = 17）完成了检查表，所有参与者（n = 32 dyads）完成了研究。患者和同伴表示，该检查表易于完成（88%）和有用（91%），他们一致（100%）推荐给其他患者。在干预组访视中，沟通更以患者为中心（比率为1.22 vs 0.71;P= 0.03）。干预组和对照组的访视持续时间（35.0和30.6分钟;P= 0.34）以及患者和同伴贡献的总言语活动百分比（58.2%和56.3%的访视陈述;P= 0.50）分别相当。医生更可能表示干预同伴“帮助他们为患者提供良好的护理”（94% vs 60%;P= 0.02）。干预患者更有可能表示，他们“更好地理解他们的医生的建议和解释”，因为他们的同伴在场（82%比47%;P= .03）。
ObjectivesTo determine the acceptability of a pre‐consultation checklist for older adults who attend medical visits with an unpaid companion and to evaluate its effects on visit communication.DesignRandomized controlled pilot study.SettingAcademic geriatrics ambulatory clinic.ParticipantsThirty‐two individuals aged 65 and older and their unpaid companions.InterventionA self‐administered checklist was compared with usual care. The checklist was designed to elicit and align patient and companion perspectives regarding health concerns to discuss with the doctor and stimulate discussion about the companion's role in the visit.MeasurementPrimary outcome: ratio of patient‐centered communication, coded from visit audiotapes. Secondary outcomes: checklist acceptability; visit duration; patient‐companion verbal activity; patient‐ and physician‐reported perspectives of the visit.ResultsAll intervention patients and companions (n = 17) completed the checklist, and all participants (n = 32 dyads) completed the study. Patients and companions stated that the checklist was easy to complete (88%) and useful (91%), and they uniformly (100%) recommended it to other patients. Communication was significantly more patient‐centered in intervention group visits (ratio of 1.22 vs 0.71;P= .03). Visit duration (35.0 and 30.6 minutes;P= .34) and percentage of total verbal activity contributed by patients and companions (58.2% and 56.3% of visit statements;P= .50) were comparable in the intervention and control groups, respectively. Physicians were more likely to indicate that intervention companions “helped them provide good care to the patient” (94% vs 60%;P= .02). Intervention patients were more likely to indicate that they “better understood their doctor's advice and explanations” because their companion was present (82% vs 47%;P= .03).ConclusionA checklist to elicit and align perspectives of older adults and their companions resulted in enhanced patient‐centered medical visit communication.