Family presence in routine medical visits: a meta-analytical review.
Family presence in routine medical visits: a meta-analytical review.
复制标题
DOI：
10.1016/j.socscimed.2011.01.015
复制
发表时间：
2011-03
影响因子：
5.4
通讯作者：
Roter, Debra L.
中科院分区：
文献类型：
--
作者：
Wolff, Jennifer L.;Roter, Debra L.
关键词：
老年人通常由成年子女和配偶陪同进行常规医生检查。这是调查患者陪伴的动态和后果的研究的第一次回顾。两种类型的证据被检查：(1)音频和/或录像医疗访问的观察性研究，以及(2)对患者，家属或医疗保健提供者的调查，以确定在常规医疗访问中家庭伴侣在场和行为的经验，期望和偏好。荟萃分析技术用于总结描述无人陪伴和陪同患者及其同伴、医疗访问过程和患者结果的属性的证据。在13项有贡献的研究中，患者陪同常规成人医疗就诊的加权平均率为37.6%。与无人陪伴的患者相比，陪伴患者明显年龄更大，更可能是女性，受教育程度更低，身心健康状况更差。陪伴患者的平均年龄为63岁，主要为女性（79.4%），患者的配偶（54.7%）或成年子女（32.2%）。有陪伴的患者就诊时间明显更长，但与无陪伴的患者相比，有陪伴的患者及其家属对医疗对话的口头贡献是相当的。当有同伴在场时，医疗保健提供者提供了更多的生物医学信息。考虑到结果的多样性，汇总估计无法计算：在5项有贡献的研究中，0项研究不利，3项研究不确定，2项研究有利于陪伴患者相对于无陪伴患者。研究结果表明，在卫生保健提供过程中更系统地认识和整合同伴可能带来实际好处。我们提出了一个概念框架，将家庭伴侣的存在和医生就诊期间的行为与人际卫生保健过程的质量、患者自我管理和卫生保健联系起来。
Older adults are commonly accompanied to routine physician visits, primarily by adult children and spouses. This is the first review of studies investigating the dynamics and consequences of patient accompaniment. Two types of evidence were examined: (1) observational studies of audio and/or videotaped medical visits, and (2) surveys of patients, families, or health care providers that ascertained experiences, expectations, and preferences for family companion presence and behaviors in routine medical visits. Meta-analytic techniques were used to summarize the evidence describing attributes of unaccompanied and accompanied patients and their companions, medical visit processes, and patient outcomes. The weighted mean rate of patient accompaniment to routine adult medical visits was 37.6% in 13 contributing studies. Accompanied patients were significantly older and more likely to be female, less educated, and in worse physical and mental health than unaccompanied patients. Companions were on average 63 years of age, predominantly female (79.4%), and spouses (54.7%) or adult children (32.2%) of patients. Accompanied patient visits were significantly longer, but verbal contribution to medical dialogue was comparable when accompanied patients and their family companion were compared with unaccompanied patients. When a companion was present, health care providers engaged in more biomedical information giving. Given the diversity of outcomes, pooled estimates could not be calculated: of 5 contributing studies 0 were unfavorable, 3 inconclusive, and 2 favorable for accompanied relative to unaccompanied patients. Study findings suggest potential practical benefits from more systematic recognition and integration of companions in health care delivery processes. We propose a conceptual framework to relate family companion presence and behaviors during physician visits to the quality of interpersonal health care processes, patient self management and health care.
登录
查看更多内容
影响因子：
5.7
作者：
Mast, Marianne Schmid;Hall, Judith A.;Roter, Debra L.
通讯作者：
Roter, Debra L.
影响因子：
3.5
作者：
Hall, JA;Horgan, TG;Roter, DL
通讯作者：
Roter, DL
影响因子：
5.4
作者：
Charles, C;Gafni, A;Whelan, T
通讯作者：
Whelan, T
影响因子：
5.4
作者：
Clayman, ML;Roter, D;Bandeen-Roche, K
通讯作者：
Bandeen-Roche, K
影响因子：
3
作者：
Hall, JA;Roter, DL;Daltroy, LH
通讯作者：
Daltroy, LH