感知到的获取,感知到的治疗需要,以及为COPD恶化寻求护理的决定
Vincent S Fan1,2, Paul L Hebert3,4, Emily R Locke3
1Center of Innovation for Veteran-Centered and Value-Driven Care VA Puget Sound Health Care System, Seattle, WA, USA. vfan@uw.edu.
Journal of general internal medicine
|September 16, 2025
概括
患有慢性阻塞性肺病 (COPD) 的患者对症状感到焦虑,更早地寻求治疗. 获得肺部医疗服务提供者也可以改善对COPD恶化的及时护理.
科学领域:
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
- 患者报告的结果
背景情况:
- 慢性阻塞性肺病 (COPD) 恶化的延迟治疗延长了恢复时间,并增加了紧急诊所的风险.
- 患者在恶化期间寻求护理的决定受到多种因素的影响.
研究的目的:
- 在寻求COPD恶化及时治疗的决策过程中,调查对感知护理需求和获得护理的相对重要性.
- 确定患者报告的关键因素,影响COPD恶化期间寻求护理的行为.
主要方法:
- 这是一项为期一年的前性队列研究,涉及退伍军人事务部 (VA) 的410名COPD患者.
- 数据收集包括基线螺旋测量,心理社会因素,感知到的访问和护理需求的问卷.
- 每两周一次的接触发现了恶化,随后收集了关于症状,寻求护理和医疗保健利用的数据,包括对症状反应问卷.
主要成果:
- 对356名参与者的1094次恶化的分析显示,高焦虑反应的症状与寻求护理的可能性增加相关.
- 相反,对症状的高度感知控制与寻求护理的可能性较低有关.
- 获得VA肺部提供者的机会与早期寻求恶化的护理有显著联系.
结论:
- 感知对护理的需要,特别是对症状的情绪反应,在VA系统内显著影响COPD恶化治疗的寻求护理行为.
- 解决患者对恶化呼吸道症状的情绪和认知反应对于开发促进及时和适当治疗的干预措施至关重要.
- 改善对肺部医疗服务提供者的准入,可以促进对COPD恶化的早期干预.
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