在喀拉拉邦的初级保健中,老年人与多种疾病的共同决策:使用社会生态模型进行定性研究
Abhijith A Kumar1, Asha Kamath1, Lena Ashok2
1Department of Applied Statistics and Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.
Frontiers in public health
|October 13, 2025
概括
喀拉拉邦有多种健康状况的老年人面临着在初级保健中共同决策 (SDM) 的障碍,原因是健康素养和文化因素较低. 改善沟通和家庭参与是提高以患者为中心的护理的关键.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多病症对老年人来说是一个日益严重的公共卫生问题,特别是在印度的喀拉拉邦.
- 共享决策 (SDM) 对于以人为中心的护理至关重要,但在低收入和中等收入国家 (LMICs) 应用不一致.
研究的目的:
- 探索Kerala的初级保健机构中关于SDM的多病症老年人的经验和观点.
- 确定影响SDM的个人,人际,组织和社会文化因素.
主要方法:
- 这项定性研究涉及来自喀拉拉邦四个初级卫生中心的60岁以上多病症16名成年人.
- 以社会生态模型为指导的有目的抽样和主题分析.
主要成果:
- 个人障碍 (低健康素养,自我效能) 导致患者被动参与.
- 家庭参与显著影响了医疗保健互动.
- 组织上的约束 (高患者负担,时间限制) 和社会文化因素 (尊重医疗权威,多元化的健康追求) 影响了SDM.
- 从SDM中排除与患者不满和治疗坚持不良相关.
结论:
- 解决卫生素养,沟通,家庭参与和文化敏感性的障碍是必不可少的.
- 需要协调努力,以推进以人为中心的护理,并改善LMIC中多病症的老年人SDM.
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