How patients' experiences contribute to decision making: illustrations from DIPEx (personal experiences of health and illness)
How patients' experiences contribute to decision making: illustrations from DIPEx (personal experiences of health and illness)
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DOI：
10.1111/j.1365-2834.2008.00863.x
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发表时间：
2008-05-01
影响因子：
5.5
通讯作者：
Herxheimer, Andrew
中科院分区：
文献类型：
--
作者：
Ziebland, Sue;Herxheimer, Andrew
目的描述人们如何使用他们和其他人的经验（“经验证据”），使卫生保健decisions.Background面临健康决策的人可能不仅采用临床证据和建议，但也有自己以前的经验和经验的其他人谁面临着类似的决定。专业人士很少注意到人们的使用这种经验的证据和它在实践中的重要性，承认它会改善与patient.Methods沟通的数据来自DIPEX（个人的健康和疾病的经验）项目，其中涉及严格的分析叙事采访的人与特定的条件，选择代表最广泛的可行范围内的经验，每种条件。每个集合包括40-50个访谈。结果在网站（http：//www.example.com）上为患者和专业人员总结了人们的经验分析，并通过访谈的剪辑（视频，音频或书面）进行了说明。www.dipex.org我们借鉴了DIPEX进行的定性研究，考虑一些不同的方式，人们整合经验的信息，当他们面对的决定，产前筛查，儿童免疫接种和治疗cancer.Conclusions其他患者的经验是一个重要的组成部分，人们使用的证据，当决策有关医疗保健。人们很自然地会被别人的故事所吸引，这些故事为医学信息增添了显著性，使事实变得可口和难忘。病人的经历不是证据基础的替代品--它们是证据基础的一部分;把它们当作“轶事”而不予考虑是一种严重的误解。在社会科学传统的基础上，有一些既定的方法可以用来研究和报告患者的经历。卫生专业人员，以及患者，需要考虑和重视这一经验evidence.Implications护理管理经理和临床医生可以帮助患者引导他们的信息资源，如DIPEX，目前循证健康信息，通过患者的经验。
Aim To describe how people use their and other people's experiences ('experiential evidence') in making health care decisions.Background People faced with health decisions may employ not only clinical evidence and advice, but also their own previous experiences and the experiences of others who have faced similar decisions. Professionals have taken little notice of people's use of such experiential evidence and its importance in practice; acknowledging it would improve communication with patients.Methods The data come from the DIPEx (personal experiences of health and illness) project, which involves rigorous analysis of narrative interviews of people with particular conditions, chosen to represent the widest practicable range of experiences of each condition. Each collection consists of 40-50 interviews. Results The analyses of people's experiences are summarized for patients and professionals on a website (http://www.dipex.org) and illustrated by clips (video, audio or written) from the interviews. We draw on the qualitative research conducted for DIPEx to consider some of the different ways that people integrate experiential information when they face decisions about antenatal screening, childhood immunization and treatment for cancer.Conclusions Other patients' experiences are an important part of the evidence that people use when making decisions about health care. People are naturally drawn to other people's stories, which add salience to medical information and make facts palatable and memorable. Patients' experiences are not an alternative to the evidence base - they are part of it; to dismiss them as 'anecdotes' is a serious misunderstanding. There are established methods, grounded in social science traditions, which can be used to research and report patients' experiences. Health professionals, as well as patients, need to consider and value this experiential evidence.Implications for Nursing Management Managers and clinicians can help patients by guiding them to information resources, such as DIPEx, that present evidence-based health information through patients' experiences.