Patient-held records in cancer and palliative care: a randomized, prospective trial
Patient-held records in cancer and palliative care: a randomized, prospective trial
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DOI：
10.1191/0269216302pm541oa
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发表时间：
2002-05-01
影响因子：
4.4
通讯作者：
Bond, S
中科院分区：
文献类型：
--
作者：
Cornbleet, MA;Campbell, P;Bond, S
目的：前瞻性评价在晚期癌症和姑息治疗需求患者的管理中引入患者保留记录（PHR）。设计：a）前瞻性、平行组、随机对照试验。B）一项关于其患者有PHR的卫生专业人员意见的邮政调查。设置：格拉斯哥和爱丁堡的门诊肿瘤中心，苏格兰中部地区的临终关怀家庭护理服务。参与者：共有244例晚期癌症患者从肿瘤门诊或临终关怀家庭护理服务招募。231例患者完成了基线访谈，117例随机接受PHR。4至6个月后，80例PHR患者和97例未接受访谈。在83名护理已知收到医生促进健康报告的病人的卫生专业人员中，63人回答了邮寄的调查问卷。主要结果指标：通过基线和4-6个月后的结构化访谈确定患者对沟通的主观满意度以及患者与医疗保健专业人员之间沟通的感知。结果如下：我们无法确定在向患者提供信息方面或患者对门诊医生、全科医生、执业和社区护士以及临终关怀或姑息性家庭护理人员提供的信息的满意度方面没有任何改善。总体而言，患者对参与其护理的所有工作人员之间的沟通的感知分别为24%和21%，或56%和58%（P=0.89）。PHR没有区别的信息传递之间的卫生专业人员，或家庭参与的程度。大多数有记录的人发现它有一些用处和好处。结论：这项研究没有提供任何证据来支持PHRs的广泛推广，尽管有临床医生和患者参与的地方项目可能很受欢迎和有效。
Objectives: To evaluate prospectively the introduction of a patient-held record (PHR) in the management of patients with advanced cancer and palliative care needs. Design: a) A prospective, parallel group, randomized controlled trial. b) A postal survey of the opinions of health professionals whose patients had a PHR. Setting: Out-patient oncology centres in Glasgow and Edinburgh, hospice home-care services across the central belt in Scotland. Participants: A total of 244 patients with advanced cancer recruited either from oncology outpatient clinics or hospice home-care services. The baseline interview was completed by 231 patients and 117 were randomized to receive the PHR. Between 4 and 6 months later, 80 patients with the PHR and 97 without were interviewed. Of the 83 health professionals caring for patients known to have received the PHR 63 replied to a postal questionnaire. Main outcome measures: Subjective views of patient satisfaction with communication and perception of communication between patient and health care professionals as determined by structured interview at baseline and after 4-6 months. Results: We could identify no improvement in the provision of information to patients, or patients' satisfaction with information provided by outpatient doctors, GPs, practice and community nurses and hospice or palliative home care staff. Overall, patients' perception of communication between all staff involved in their care with and without PHRs was excellent in 24% and 21%, respectively, or very good in 56% and 58% (P=0.89). The PHR made no difference to information passing between health professionals, or to the degree of family involvement. Most of those who had a record found it of some use and benefit. Conclusion: This study provides no evidence on which to base the widespread promotion of PHRs, although local projects with committed clinicians and patients may well prove popular and effective.