Digital tools as promoters for person-centered care practices in chronic care? Healthcare professionals' experiences from rheumatology care.
Digital tools as promoters for person-centered care practices in chronic care? Healthcare professionals' experiences from rheumatology care.
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数字工具是慢性护理中以人为本护理实践的促进者？风湿病护理中的医疗保健专业人员经验。
DOI：
10.1186/s12913-020-05945-5
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发表时间：
2020-12-01
影响因子：
2.8
通讯作者：
Nyström ME
中科院分区：
文献类型：
--
作者：
Granström E;Wannheden C;Brommels M;Hvitfeldt H;Nyström ME
以人为本的护理 (PCC) 强调支持个人参与提供的护理和自我护理的重要性。由于人口变化，患有慢性病的人数不断增加，PCC 在慢性病护理中变得越来越重要。数字工具有潜力支持患者和医疗保健提供者之间的互动，但如何在慢性病护理中实现 PCC 以及数字工具在此过程中的作用的经验例子是有限的。本研究的目的是调查风湿病门诊 (RC) 的医疗保健专业人员使用的实现 PCC 的策略、这些策略与数字工具的关系以及这些策略对医疗保健专业人员和患者的感知影响。使用了单一案例研究设计。定性数据包括 14 次半结构化访谈和员工会议纪要，涵盖 2017 年至 2019 年期间。使用传统的内容分析并辅以文档分析来分析数据。确定了两个层面上实施 PCC 的十项战略，以及三类感知影响。在个体患者层面，策略涉及多种数字工具，重点关注灵活获得护理、相互信息共享以及从提供者到患者的举措、任务和责任的分配。在单位层面，涉及患者代表和个体患者参与数字服务和工作实践开发的策略。专业人员和患者的角色都受到影响，行为和文化变革的重要性变得显而易见。通过提供慢性病护理的实证案例，该研究有助于了解实现 PCC 的策略、数字工具和工作实践如何相互作用，以及它们如何影响医护人员、患者和单位。结论是，数字工具的使用跨越不同的参与维度，促进了医疗保健专业人员与患者的互动以及患者参与自己的护理。数字工具补充而不是取代护理实践。
Person-centered care (PCC) emphasize the importance of supporting individuals’ involvement in care provided and self-care. PCC has become more important in chronic care as the number of people living with chronic conditions is increasing due to the demographic changes. Digital tools have potential to support interaction between patients and healthcare providers, but empirical examples of how to achieve PCC in chronic care and the role of digital tools in this process is limited. The aim of this study was to investigate strategies to achieve PCC used by the healthcare professionals at an outpatient Rheumatology clinic (RC), the strategies’ relation to digital tools, and the perceived impact of the strategies on healthcare professionals and patients. A single case study design was used. The qualitative data consisted of 14 semi-structured interviews and staff meeting minutes, covering the time period 2017–2019. The data were analyzed using conventional content analysis, complemented with document analyses. Ten strategies on two levels to operationalize PCC, and three categories of perceived impact were identified. On the individual patient level strategies involved several digital tools focusing on flexible access to care, mutual information sharing and the distribution of initiatives, tasks, and responsibilities from provider to patients. On the unit level, strategies concerned involving patient representatives and individual patients in development of digital services and work practices. The roles of both professionals and patients were affected and the importance of behavioral and cultural change became clear. By providing an empirical example from chronic care the study contributes to the knowledge on strategies for achieving PCC, how digital tools and work practices interact, and how they can affect healthcare staff, patients and the unit. A conclusion is that the use of the digital tools, spanning over different dimensions of engagement, facilitated the healthcare professionals’ interaction with patients and the patients’ involvement in their own care. Digital tools complemented, rather than replaced, care practices.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
5.4
作者：
Liberati, Elisa Giulia;Gorli, Mara;Scaratti, Giuseppe
通讯作者：
Scaratti, Giuseppe
影响因子：
1.3
作者：
Jones, Carol S.
通讯作者：
Jones, Carol S.
影响因子：
120.7
作者：
Bodenheimer, T;Wagner, EH;Grumbach, K
通讯作者：
Grumbach, K
影响因子：
5.4
作者：
Batalden, Maren;Batalden, Paul;Hartung, Hans
通讯作者：
Hartung, Hans