在高风险多病症患者中,个人价值观与健康之间的感知联系:一种定性研究
Linnaea Schuttner1,2, Jonathan Staloff3,4, Mariah Theis3
1Seattle-Denver Center of Innovation, Health Services Research, VA Puget Sound Health Care System, Seattle, WA, USA. linnaea.schuttner@va.gov.
Journal of general internal medicine
|March 4, 2025
概括
具有多种健康状况的高风险患者很少在医疗保健中讨论个人价值观. 当他们这样做时,与健康决策的联系是特定于环境的,并不是所有患者都希望分享他们的价值观.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 质量健康研究 质量健康研究
- 以患者为中心的护理
背景情况:
- 医疗保健系统越来越专注于全身护理和针对多病症患者的个性化健康规划.
- 了解患者的价值观对于有效的个性化护理至关重要,但很少有研究对高风险多病症患者来说探索这一点.
研究的目的:
- 探索多病症高风险患者如何感知他们个人价值观与健康,医疗保健经验和决策之间的联系.
主要方法:
- 一个定性研究,涉及个人半结构化的电话采访.
- 参与者是患有多种慢性疾病 (抑郁症,高血压,慢性病或糖尿病) 的高风险 (≥75百分位) 住院或死亡的患者.
- 采访被分析使用内容分析.
主要成果:
- 在医疗保健环境中,个人价值观很少被讨论或纳入决策,一些患者认为这些价值观不那么重要.
- 价值观与健康决策之间的联系主要是在特定的环境中观察到的,例如手术选择.
- 引起个人价值观的后果各不相同;并非所有患者都愿意披露这些价值观,而且对披露的偏好也各不相同.
结论:
- 患有多重疾病的高风险患者报告说,在医疗保健中对个人价值观的讨论有限,感知到的相关性往往取决于背景.
- 虽然一些患者发现分享个人信仰是有价值的,但其他人宁愿不透露,强调需要考虑患者的偏好.
- 整合患者价值观需要了解个人的偏好,以获得和纳入护理计划.
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