多病症与患者对全科医生的体验:挪威全国横断面调查

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Rebecka Maria Norman, Elma Jelin, Oyvind Bjertnaes
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引用次数: 0

摘要

患者体验是衡量医疗质量的一个重要指标。身患多种疾病的患者通常会面临不良的健康后果和更高的医疗使用率。全科医生在管理这些患者方面发挥着至关重要的作用。我们研究的主要目的是深入评估慢性病患者、多病共患患者和无慢性病患者在患者报告的全科医生经验方面的差异。我们对 2021 年的一项全国性患者全科就医体验调查(回复率为 41.9%,n=7912)进行了二次分析。我们描述了所有自我报告无慢性病、有一种、两种和三种或三种以上慢性病的调查对象的特征。我们使用挪威全科医生患者体验问卷(PEQ-GP)中的四个量表来评估患者体验。这些量表在双变量和多变量分析中用作因变量,并用于测试测量模型,包括确证因子分析和多组 CFA,以评估测量不变性。此外,还对自由文本评论进行了情感和内容分析。与非慢性病患者相比,慢性病患者在全科医生和全科医生实践经验量表上的得分一直较低。即使在对患者背景变量进行调整后,这种模式依然存在。与 "使能 "量表的关联性最强,其次是 "全科医生 "和 "实践 "量表。在统计学上,"可及性 "子量表与任何慢性病的相关性都不明显。对自由文本评论的分析与量化结果相吻合。与无慢性疾病的患者相比,多病患者更常强调就诊时间、与同一位全科医生见面、随访和关系的重要性。我们的研究还证实了无慢性病患者和多病患者之间的测量不变性,这表明观察到的患者体验差异是真实差异的结果,而不是测量偏差的假象。研究结果凸显了医疗系统为慢性病患者和多病症患者提供定制化支持的必要性。满足多病患者的特殊需求是提高患者体验和全科医疗质量的关键一步。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multimorbidity and patient experience with general practice: A national cross-sectional survey in Norway
Patient experience is an important indicator of the quality of healthcare. Patients with multimorbidity often face adverse health outcomes and increased healthcare utilisation. General practitioners play a crucial role in managing these patients. The main aim of our study was to perform an in-depth assessment of differences in patient-reported experience with general practice between patients living with chronic conditions and multimorbidity, and those with no chronic conditions. We performed secondary analyses of a national survey of patient experience with general practice in 2021 (response rate 41.9%, n = 7,912). We described the characteristics of all survey respondents with no, one, two, and three or more self-reported chronic conditions. We assessed patient experience using four scales from the Norwegian patient experience with GP questionnaire (PEQ-GP). These scales were used as dependent variables in bivariate and multivariate analyses and for testing the measurement model, including confirmatory factor analysis and a multigroup CFA to assess measurement invariance. Sentiment and content analysis of free-text comments was also performed. Patients with chronic conditions consistently reported lower scores on the GP and GP practice experience scales, compared to those without chronic conditions. This pattern persisted even after adjustment for patient background variables. The strongest associations were found for the scale of “Enablement”, followed by the scales of “GP” and “Practice”. The subscale “Accessibility” did not correlate statistically significantly with any number of chronic conditions. The analysis of free-text comments echoed the quantitative results. Patients with multimorbidity stressed the importance of time spent on consultations, meeting the same GP, follow-up and relationship more often than patients with no chronic conditions. Our study also confirmed measurement invariance across patients with no chronic conditions and patients with multimorbidity, indicating that the observed differences in patient experience were a result of true differences, rather than artifacts of measurement bias. The findings highlight the need for the healthcare system to provide customised support for patients with chronic conditions and multimorbidity. Addressing the specific needs of patients with multimorbidity is a critical step towards enhancing patient experience and the quality of care in general practice.
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来源期刊
BMC Family Practice
BMC Family Practice 医学-医学:内科
CiteScore
3.20
自引率
0.00%
发文量
0
审稿时长
4-8 weeks
期刊介绍: BMC Family Practice is an open access, peer-reviewed journal that considers articles on all aspects of primary health care research. The journal has a special focus on clinical decision making and management, continuing professional education, service utilization, needs and demand, and the organization and delivery of primary care and care in the community.
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