开发和评估 SEE-糖尿病:以患者为中心的糖尿病 Car 教育决策支持系统。

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Ploypun Narindrarangkura, Siroj Dejhansathit, Uzma Khan, Margaret Day, Suzanne A. Boren, Eduardo J. Simoes, Min S. Kim
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引用次数: 0

摘要

研究目的这项可行性研究评估了 "支持-参与-赋权-糖尿病"(SEE-Diabetes)的有效性,这是一种以患者为中心的教育工具,旨在促进老年人在糖尿病管理方面的共同决策。我们的目标是评估 SEE-Diabetes 促进患者参与和合作目标设定的能力,并通过观察性患者参与(OPTION)量表和共同决策问卷(SDM-Q-Doc)进行测量。我们假设,这些工具将有效区分积极利用 SEE-Diabetes 引导以患者为中心的对话并设定目标的医疗服务提供者和不积极利用 SEE-Diabetes 引导以患者为中心的对话并设定目标的医疗服务提供者:密苏里大学医疗保健中心在模拟临床会诊中使用了经过 4 年以用户为中心的设计过程开发的 SEE-Diabetes。我们使用视频录像对 12 次临床会诊进行了分析。该分析采用混合方法,涉及三名模拟患者和四名医疗服务提供者(两名内科医生和两名外科医生)。我们通过 SDM-Q-Doc、OPTION 量表和对话分析使用 SEE-Diabetes 评估了决策过程:在满分 100 分的情况下,SDM-Q-Doc 和 OPTION 量表的平均得分分别为 52.6 分和 75.9 分。我们的研究结果表明,医疗服务提供者在与患者互动时积极使用 SEE-Diabetes 是促进共同决策和制定以患者为中心的目标的有效媒介。那些积极利用 SEE-Diabetes 来引导对话、提出开放式问题并将患者意见纳入目标设定的医疗服务提供者,其 OPTION 和 SDM-Q-Doc 得分明显高于那些较少使用该工具或主要出于记录目的而使用该工具的医疗服务提供者。医疗服务提供者给予了积极的反馈,强调了该工具的简洁性和以患者为中心的特点,并对将 SEE-Diabetes 纳入他们未来的医疗实践持乐观态度:结论:SEE-Diabetes 在改善患者与医疗服务提供者之间的互动方面显示出了巨大的潜力,为老年人的糖尿病管理提供了一种创新方法。该工具不仅有可能消除沟通障碍,还能让患者在医疗决策中发挥更积极的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Developing and Evaluating SEE-Diabetes: A Patient-Centered Educational Decision Support System for Diabetes Care

Objectives

This feasibility study evaluated the effectiveness of Support-Engage-Empower-Diabetes (SEE-Diabetes), a patient-centered educational tool designed to promote shared decision-making of diabetes management in older adults. We aimed to assess SEE-Diabetes's ability to facilitate patient engagement and collaborative goal setting, as measured by the Observational Patient Involvement (OPTION) scale and Shared Decision-Making Questionnaire (SDM-Q-Doc). We hypothesized that these instruments would effectively differentiate between healthcare providers who actively leveraged SEE-Diabetes to guide patient-centric conversations and set goals compared to those who did not.

Methods

SEE-Diabetes, developed through a 4-year user-centered design process, was employed in simulated clinical encounters at the University of Missouri Health Care. We conducted an analysis of 12 clinical encounters using video recordings. This analysis involved three simulated patients and four providers, two internals and two externals, utilizing a mixed-methods approach. We assessed the decision-making process using SEE-Diabetes by SDM-Q-Doc, OPTION scale, and conversation analysis.

Results

The average scores for the SDM-Q-Doc and the OPTION scale, out of a possible 100, were 52.6 and 75.9, respectively. Our findings revealed that active provider engagement with SEE-Diabetes during patient interactions served as an effective medium to facilitate shared decision-making and to set patient-centered goals. Providers who actively utilized SEE-Diabetes to guide conversations, ask open-ended questions, and incorporate patient input into goal setting demonstrated significantly higher OPTION and SDM-Q-Doc scores compared to those who used the tool less frequently or primarily for documentation purposes. Providers expressed positive feedback, highlighting its conciseness, patient-centricity, and optimism about integrating SEE-Diabetes into their future practices.

Conclusion

SEE-Diabetes showed considerable promise in improving interactions between patients and providers, presenting an innovative approach to diabetes management for older adults. This tool has the potential to not only close communication gaps but also enable patients to take a more active role in their healthcare decisions.

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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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