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首页> 外文期刊>COPD: Journal of Chronic Obstructive Pulmonary Disease >Improving COPD Care in a Medically Underserved Primary Care Clinic: A Qualitative Study of Patient Perspectives
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Improving COPD Care in a Medically Underserved Primary Care Clinic: A Qualitative Study of Patient Perspectives

机译：在医疗不足的基层医疗诊所中改善COPD护理：患者观点的定性研究

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We conducted a focus group study in an urban hospital-based primary care teaching clinic serving an indigent and Hispanic (predominantly Puerto Rican) population in New England in order to learn how patients with Chronic Obstructive Lung Disease (COPD) perceive their disease, how they experience their medical care, and the barriers they face managing their disease and following medical recommendations. The research team included medical doctors, nurses, a medical anthropologist, a clinical pharmacist, a hospital interpreter, and a systems analyst. Four focus groups were conducted in Spanish and English in April and May 2014. The demographic characteristics of the 25 focus group participants closely reflected the demographics of the total COPD clinic patients. The participants were predominantly female (72%) and Hispanic (72%) and had a median age of 63. The major themes expressed in the focus groups included: problems living with COPD; coping with complexities of comorbid illnesses; challenges of quitting smoking and maintaining cessation; dealing with second-hand smoke; beliefs and myths about quitting smoking; difficulty paying for and obtaining medications; positive experiences obtaining and managing medications; difficulties in using sleep machines at home; expressions of disappointment with the departure of their doctors; and overall satisfaction with the clinic health care providers. The study led to the creation of an action plan that addresses the concerns expressed by the focus study participants. The action plan is spearheaded by a designated bilingual and bicultural nurse and is now in operation.
机译：我们在一家以城市医院为基础的基层医疗教学诊所中进行了焦点小组研究，该诊所为新英格兰的贫困和西班牙裔（主要是波多黎各人）提供服务，以了解患有慢性阻塞性肺病（COPD）的患者如何看待疾病，体验他们的医疗保健，以及他们在管理疾病和遵循医疗建议方面面临的障碍。研究团队包括医生，护士，医学人类学家，临床药剂师，医院口译员和系统分析员。 2014年4月和2014年5月，以西班牙语和英语进行了四个焦点小组讨论。25个焦点小组参与者的人口统计学特征紧密反映了COPD诊所患者总数。参与者主要是女性（72％）和西班牙裔（72％），中位年龄为63岁。应对并存疾病的复杂性;戒烟和维持戒烟的挑战;处理二手烟;关于戒烟的信念和神话;难以支付和获得药物;获得和管理药物的积极经验;在家中使用睡眠机器有困难;对医生离职感到失望;对诊所医疗服务提供者的总体满意度。该研究导致制定了一项行动计划，以解决重点研究参与者表达的关注。该行动计划由一名指定的双语和双文化护士带头，目前正在实施。

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