Early evaluation of experiences of health care providers in reception centers with a patient-held personal health record for asylum seekers: a multi-sited qualitative study in a German federal state.
Early evaluation of experiences of health care providers in reception centers with a patient-held personal health record for asylum seekers: a multi-sited qualitative study in a German federal state.
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DOI：
10.1186/s12992-018-0394-1
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发表时间：
2018-07-20
影响因子：
10.8
通讯作者：
Bozorgmehr K
中科院分区：
文献类型：
--
作者：
Jahn R;Ziegler S;Nöst S;Gewalt SC;Straßner C;Bozorgmehr K
向寻求庇护者提供高质量的医疗服务是欧洲联盟许多国家面临的一项主要挑战。特别是，由于移民的轨迹使寻求庇护者在欧洲各国之间和内部流动，护理的连续性一直难以实现。患者拥有的个人健康记录(PHR)已被提出，以促进卫生部门和提供者之间的病历转移，但到目前为止，还没有数据支持其在移民环境中的使用。本文件通过探讨寻求庇护者接待中心的医疗保健提供者使用病人持有的PHR的经验和做法，以及所认为的相关好处和缺点，解决了这一知识差距。通过2016年11月至2017年1月期间在德国巴登-符腾堡州五个城市的六个寻求庇护者接待中心进行的多地点定性研究进行早期评估。本研究评估的PHR于2016年2月至10月期间在其中五个接待中心实施；其余一个仅通过从其他设施转院接受PHR患者。对在这些接待中心工作的医生和护士进行了17次访谈，探讨他们关于患者持有的PHR的经验、常规和观点。访谈按照主题分析的方法进行记录、转录和分析。医疗保健提供者认识到患者持有的PHR具有改善获取病历的潜力。他们使用PHR记录他们的医疗咨询并收集其他医疗报告。然而，医生对患者持有的PHR的依从性被描述为不令人满意，特别是在外部医生中，因此限制了其直接好处。遵从率低的原因包括在实施前缺乏信息、工作条件苛刻且几乎没有支持、根据环境的分散程度而感觉到的好处较低、其他文件平台的并行存在以及紧张的患者关系。患者持有的PHR可以改善接待中心的健康相关信息的可用性，如果一个上下文敏感的实施过程实现了医生对PHR的高度遵守以及患者的高依从性，并包括关于将其充分整合到当地日常工作中的指导方针。本文的在线版本(10.1186/s12992-0180394-1)包含补充材料，可供授权用户使用。
The provision of high-quality medical care to asylum seekers represents a key challenge in many countries of the European Union. Especially continuity of care has been difficult to achieve as the migrant trajectory moves asylum seekers across and within European countries. Patient-held personal health records (PHR) have been proposed to facilitate the transfer of medical history between health sectors and providers, but so far there is no data to support its use in the migrant setting. The present paper addresses this knowledge gap by exploring the experiences and practices of healthcare providers in reception centers for asylum seekers using a patient-held PHR as well as the perceived associated benefits and shortcomings. Early evaluation by means of a multi-sited qualitative study in six asylum seeker reception centers in five cities in the German state of Baden-Wuerttemberg, conducted between November 2016 and January 2017. The PHR evaluated in this study was implemented in five of these reception centers between February and October 2016; the remaining one only receiving patients with the PHR through transfer from the other facilities. 17 interviews were conducted with physicians and nurses working at these reception centers exploring their experiences, routines, and perspectives regarding the patient-held PHR. The interviews were recorded, transcribed and analyzed following the approach of thematic analysis. Healthcare providers recognise the potential of a patient-held PHR to improve access to medical history. They use the PHR to document their medical consultations and to collect other medical reports. However, physician adherence to the patient-held PHR was described as unsatisfactory, in particular among external doctors, thus limiting its immediate benefit. Reasons given for this low adherence included lack of information before implementation, demanding working conditions with little support, low perceived benefits depending on the degree of fragmentation of settings, parallel existence of other documentation platforms and strained patient relationships. A patient-held PHR could improve the availability of health-related information in reception centers if a context-sensitive implementation process achieves high adherence to the PHR among physicians as well as high patient compliance and includes guidelines regarding its adequate integration into local routines. The online version of this article (10.1186/s12992-018-0394-1) contains supplementary material, which is available to authorized users.
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影响因子：
4.5
作者：
Priebe S;Sandhu S;Dias S;Gaddini A;Greacen T;Ioannidis E;Kluge U;Krasnik A;Lamkaddem M;Lorant V;Riera RP;Sarvary A;Soares JJ;Stankunas M;Strassmayr C;Wahlbeck K;Welbel M;Bogic M
通讯作者：
Bogic M
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
DOI：
10.1186/s13012-015-0242-0
发表时间：
2015-04-21
期刊：
Implementation science : IS
影响因子：
--
作者：
Nilsen P
通讯作者：
Nilsen P
影响因子：
4.4
作者：
Cornbleet, MA;Campbell, P;Bond, S
通讯作者：
Bond, S
DOI：
10.1136/qhc.0100159
发表时间：
2001-09-01
期刊：
QUALITY IN HEALTH CARE
影响因子：
--
作者：
Williams, JG;Cheung, WY;Malinovszky, K
通讯作者：
Malinovszky, K