关键词: clinical practice guidelines patient decision making qualitative methods risk communication risk perception

Mesh : Decision Making Humans Information Services Patients Practice Guidelines as Topic Qualitative Research

来  源:   DOI:10.1177/0272989X16644427   PDF(Sci-hub)

Abstract:
Clinical practice guidelines (CPGs) are typically written for health care professionals but are meant to assist patients with health care decisions. A number of guideline producers have started to develop patient versions of CPGs to reach this audience.
To describe the content and purpose of patient versions of CPGs and compare with patient and public views of CPGs.
A descriptive qualitative study with a directed content analysis of a sample of patient versions of CPGs published and freely available in English from 2012 to 2014.
We included 34 patient versions of CPGs from 17 guideline producers. Over half of the patient versions were in dedicated patient sections of national/professional agency websites. There was essentially no information about how to manage care in the health care system. The most common purpose was to equip people with information about disease, tests or treatments, and recommendations, but few provided quantitative data about benefits and harms of treatments. Information about beliefs, values and preferences, accessibility, costs, or feasibility of the interventions was rarely addressed. Few provided personal stories or scenarios to personalize the information. Three versions described the strength of the recommendation or the level of evidence.
Our search for key institutions that produce patient versions of guidelines was comprehensive, but we only included English and freely available versions. Future work will include other languages.
This review describes the current landscape of patient versions of CPGs and suggests that these versions may not address the needs of their targeted audience. Research is needed about how to personalize information, provide information about factors contributing to the recommendations, and provide access.
摘要:
临床实践指南(CPG)通常是为医疗保健专业人员编写的,但旨在帮助患者做出医疗保健决策。许多指南制作人已经开始开发CPG的患者版本以覆盖该受众。
描述患者版本的CPG的内容和目的,并与患者和公众对CPG的看法进行比较。
一项描述性定性研究,对2012年至2014年以英语免费提供的CPG患者版本样本进行了定向内容分析。
我们纳入了来自17个指南制作者的34个患者版本的CPG。超过一半的患者版本位于国家/专业机构网站的专用患者部分。基本上没有关于如何管理医疗保健系统中的护理的信息。最常见的目的是为人们提供有关疾病的信息,测试或治疗,和建议,但很少有人提供有关治疗的益处和危害的定量数据。关于信仰的信息,价值观和偏好,可访问性,成本,或干预措施的可行性很少得到解决。很少有人提供个人故事或场景来个性化信息。三个版本描述了建议的强度或证据水平。
我们对产生患者版本指南的关键机构的搜索是全面的,但我们只包括英语和免费提供的版本。未来的工作将包括其他语言。
这篇综述描述了患者版本的CPG的现状,并建议这些版本可能无法满足其目标受众的需求。需要研究如何个性化信息,提供有关影响建议的因素的信息,并提供访问。
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