Patient and public attitudes to and awareness of clinical practice guidelines: a systematic review with thematic and narrative syntheses.
Patient and public attitudes to and awareness of clinical practice guidelines: a systematic review with thematic and narrative syntheses.
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DOI：
10.1186/1472-6963-14-321
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发表时间：
2014-07-27
影响因子：
2.8
通讯作者：
Treweek S
中科院分区：
文献类型：
--
作者：
Loudon K;Santesso N;Callaghan M;Thornton J;Harbour J;Graham K;Harbour R;Kunnamo I;Liira H;McFarlane E;Ritchie K;Treweek S
临床实践指南通常是为医疗保健提供者编写的，但越来越多的人对为公众、患者和护理人员编写版本感兴趣。本综述的主要目的是识别和综合公众对临床实践指南和为提供者或公众编写的循证建议的态度的证据，以及他们对指南的认识。我们纳入了对公众、患者（及其护理人员）的态度和对为提供者或患者/公众编写的指南的认识的任何设计报告的定量和定性研究。我们检索了2000 - 2012年的MEDLINE、PSYCHINFO、ERIC、ASSIA和Cochrane Library等电子数据库。我们还搜索了相关网站，查阅了引文，联系了该领域的专家。至少有两位作者独立筛选、提取数据并评估研究质量。我们对一级和二级主题进行了专题分析，并对患者和公众对指南的认识进行了单独的叙述综合。我们回顾了5415项记录，纳入了26项研究（10项定性研究，13项横断面试验和3项随机对照试验），涉及24887名个体。研究大多质量良好。专题分析产生了四个总体主题：准则的适用性；患者指南的目的；卫生保健系统和医生指南的目的；和指南的属性。总体而言，参与者对指南的态度不一；一些参与者认为他们赋予权力，但许多人认为这是一种配给护理的方式。患者还担心，这些信息可能不适用于他们自己的保健情况。对指南的认知度从0-79%不等，在国家指南网站上接受调查的参与者的认知度更高。除格式外，还有许多因素可能影响公众对指南衍生材料的理解和使用。生产者需要明确信息与读者的相关性，以及在存在数据质量问题的情况下如何使用这些信息来改善医疗保健。人们对准则的认识普遍较低，准则的制订者不能假定公众对其材料的认识比对其他卫生信息来源的认识更积极。
Clinical practice guidelines are typically written for healthcare providers but there is increasing interest in producing versions for the public, patients and carers. The main objective of this review is to identify and synthesise evidence of the public’s attitudes towards clinical practice guidelines and evidence-based recommendations written for providers or the public, together with their awareness of guidelines. We included quantitative and qualitative studies of any design reporting on public, patient (and their carers) attitudes and awareness of guidelines written for providers or patients/public. We searched electronic databases including MEDLINE, PSYCHINFO, ERIC, ASSIA and the Cochrane Library from 2000 to 2012. We also searched relevant websites, reviewed citations and contacted experts in the field. At least two authors independently screened, abstracted data and assessed the quality of studies. We conducted a thematic analysis of first and second order themes and performed a separate narrative synthesis of patient and public awareness of guidelines. We reviewed 5415 records and included 26 studies (10 qualitative studies, 13 cross sectional and 3 randomised controlled trials) involving 24 887 individuals. Studies were mostly good to fair quality. The thematic analysis resulted in four overarching themes: Applicability of guidelines; Purpose of guidelines for patient; Purpose of guidelines for health care system and physician; and Properties of guidelines. Overall, participants had mixed attitudes towards guidelines; some participants found them empowering but many saw them as a way of rationing care. Patients were also concerned that the information may not apply to their own health care situations. Awareness of guidelines ranged from 0-79%, with greater awareness in participants surveyed on national guideline websites. There are many factors, not only formatting, that may affect the uptake and use of guideline-derived material by the public. Producers need to make clear how the information is relevant to the reader and how it can be used to make healthcare improvements although there were problems with data quality. Awareness of guidelines is generally low and guideline producers cannot assume that the public has a more positive perception of their material than of alternative sources of health information.
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影响因子：
3.4
作者：
Cameron, Christine;Craig, Cora L.;Bauman, Adrian
通讯作者：
Bauman, Adrian
影响因子：
1.6
作者：
Crocetti, M;Dudas, R;Krugman, S
通讯作者：
Krugman, S
DOI：
10.1513/pats.201208-061st
发表时间：
2012-12-01
期刊：
Proceedings of the American Thoracic Society
影响因子：
--
作者：
Kelson, Marcia;Akl, Elie A;Schunemann, Holger J
通讯作者：
Schunemann, Holger J
对基于循证的信息进行了认识 - 对背痛患者网站的定性评估。
影响因子：
2.8
作者：
Glenton, C;Nilsen, ES;Carlsen, B
通讯作者：
Carlsen, B
影响因子：
7.2
作者：
Akl, Elie A.;Maroun, Nancy;Schunemann, Holger J.
通讯作者：
Schunemann, Holger J.