权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Rethinking Doctor-Patient Relationships

重新思考医患关系

基本信息

批准号：
7236966
负责人：
Michael Joel Yedidia
金额：
$ 18.39万
依托单位：
RUTGERS, THE STATE UNIV OF N.J.
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-08-01 至 2007-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7236966
关键词：
alternative medicine behavioral /social science research tag chronic disease /disorder clinical research curriculum education evaluation /planning extended care health care model health care quality health services research tag human subject interview medical education model design /development patient care patient care personnel relations self help

项目摘要

DESCRIPTION: (Provided by the Applicant) Transformation of provider-patient relationships will be essential to the success of efforts to achieve patient-centered care, as envisioned in the IOM report, Crossing the Quality Chasm. This research will investigate new ways of structuring doctor-patient relationships by studying five innovative practices: 1 ) cancer self-help and advocacy, 2) palliative care, 3) complementary medicine, 4) group visits for chronic illness care, and 5) new communications curricula in medical education. Three research questions will be addressed through study of each of these cases: 1. How can doctor-patient relationships be restructured within the following dimensions to promote patient-centered care: exercise of authority, distribution of responsibility among patients and providers, patient access to expertise, the range of patient needs addressed, affective involvement of both parties, possibilities for authenticity, and maintenance of trust? 2. What are the critical elements that promote or impede application of these innovations in medical practice? How can relationships be reformulated to optimally address specific health problems or serve distinctive patient populations? 3. How do the new possibilities for structuring relationships posed by these cases accord with dominant theoretical perspectives on doctor-patient relationships? How might existing models be revised to more effectively guide future research? A qualitative research approach serves the overall goal of developing new models in unexplored territory. In-depth interviews will be conducted with participants in each case and inductively analyzed to: a) study the dynamics of caring focusing on those features central to effectiveness; b) compare these features across cases and in relation to prevailing models of doctor-patient relationships; c) assess conditions under which each innovation functions, its acceptability to population subgroups, and the potential to expand its application more broadly; and d) generate hypotheses about promising changes in mainstream relationships and approaches for achieving them. The study is designed, first, to illuminate new possibilities for structuring doctor-patient relationships consonant with IOM's agenda for redesign of health care processes. Second, findings will inform initiatives in medical education as a vehicle for preparing doctors to assume new roles. Third, development of new conceptual frameworks and models will guide future research on the impact of doctor-patient relationships on quality of care.

产品说明：（申请人提供）如IOM报告《跨越质量鸿沟》中所设想的那样，转变医患关系对于实现以患者为中心的护理的成功至关重要。本研究将通过研究五种创新实践来探讨构建医患关系的新方法：1）癌症自助和宣传，2）姑息治疗，3）补充医学，4）慢性病护理的团体访问，以及5）医学教育中的新沟通课程。三个研究问题将通过研究这些案件中的每一个解决： 1. 如何在以下维度内重构医患关系，以促进以患者为中心的护理：权威的行使，患者和提供者之间的责任分配，患者获得专业知识，患者需求的范围，双方的情感参与，真实性的可能性，以及信任的维护？ 2. 在医疗实践中，促进或阻碍这些创新应用的关键因素是什么？如何重新制定关系，以最佳方式解决特定的健康问题或服务于独特的患者群体？ 3. 这些病例所提出的构建医患关系的新可能性如何与关于医患关系的主流理论观点相雅阁？如何修改现有的模型，以更有效地指导未来的研究？定性研究方法服务于在未探索的领域开发新模型的总体目标。将对每个案例中的参与者进行深入访谈，并进行归纳分析，以：a）研究关注有效性核心特征的护理动态; B）比较不同案例中的这些特征，并与流行的医患关系模式进行比较; c）评估每项创新发挥作用的条件，其对人口亚组的可接受性，以及更广泛地扩大其应用的潜力;（d）提出关于主流关系中有希望的变化的假设以及实现这些变化的方法。这项研究的目的是，首先，阐明新的可能性，构建医患关系符合国际移民组织的议程，重新设计保健过程。其次，研究结果将为医学教育的举措提供信息，作为医生承担新角色的工具。第三，新的概念框架和模型的发展将指导未来的研究医患关系对医疗质量的影响。