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Involvement in shared decision-making for patients in public specialist outpatient clinics in Hong Kong

机译:参与香港公共专科门诊患者的共同决策

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Objective: This study is a preliminary exploration of the association between patient involvement in decision-making and patient socioeconomic characteristics and experience in specialist outpatient clinics (SOPCs) in Hong Kong. Methods: Cross-sectional telephone interviews were conducted using the Specialist Outpatient Experience Questionnaire (SOPEQ) in 26 Hospital Authority public SOPCs in Hong Kong. The SOPEQ was designed by The School of Public Health and Primary Care at The Chinese University of Hong Kong, fully taking into account both literature review and the local context of the public specialist outpatient system in Hong Kong. A total of 22,525 eligible participants were recruited for the study. Results: There were 13,966 valid responses. The results indicated that the patients who had more involvement in decision-making were younger (odds ratio [OR] =2.10; 95% CI 1.75, 2.53), more highly educated (OR =1.67; 95% CI 1.45, 1.93), less likely to be receiving a government allowance (OR =0.61; 95% CI 0.57, 0.65), and less likely to be in the new case group (OR =0.84; 95% CI 0.78, 0.92). Participants living with their families (OR =3.38; 95% CI 2.03, 5.63) or who were unemployed (OR =1.10; 95% CI 1.01, 1.21) had a more decisive role in the decision-making process. Those participants who had been more involved in decision-making and wanted to continue being more involved had greater levels of satisfaction (mean =7.94; P <0.001) and a better health status (OR =0.49; 95% CI 0.41, 0.58). Conclusion: Engaging patients in their health care management remains a challenge in improving patient-centered care. Our results suggest that patient engagement is associated with perceived health status and the experience of using a health service. Understanding patients’ characteristics and roles facilitates the development of preferred styles in the decision-making model.
机译:目的:本研究是对患者参与决策与患者社会经济特征与香港专业门诊(SOPC)经验之间的关联的初步探索。方法:采用专科门诊经验调查表(SOPEQ)在香港26家医院管理局的公共SOPC中进行横断面电话采访。 SOPEQ由香港中文大学公共卫生与初级保健学院设计,同时充分考虑了文献回顾和香港公共专科门诊系统的当地情况。总共招募了22,525名符合条件的参与者进行这项研究。结果:有效回复为13,966。结果表明,参与决策的患者较年轻(优势比[OR] = 2.10; 95%CI 1.75,2.53),受过高等教育的患者(OR = 1.67; 95%CI 1.45,1.93),较少可能会获得政府津贴(OR = 0.61; 95%CI 0.57,0.65),不太可能出现在新病例组中(OR = 0.84; 95%CI 0.78,0.92)。与家人同住(OR = 3.38; 95%CI 2.03,5.63)或失业的参与者(OR = 1.10; 95%CI 1.01,1.21)在决策过程中起决定性作用。那些更多地参与决策并希望继续参与进来的参与者具有更高的满意度(平均值= 7.94; P <0.001)和更好的健康状况(OR = 0.49; 95%CI 0.41,0.58)。结论:让患者参与其医疗保健管理仍然是改善以患者为中心的护理的挑战。我们的结果表明,患者的参与与感知的健康状况以及使用健康服务的经验有关。了解患者的特征和角色有助于在决策模型中发展偏好的风格。

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