مروری جامع بر مراقبتهای بیمارمحور در بیمارستان
محورهای موضوعی : -مدارک پزشکیامیر حسین فرهادفر 1 , امیراشکان نصیری پور 2 , کامران حاجی نبی 3
1 - دانشجوی دکتری مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 - دانشیار، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
3 - استادیار، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
کلید واژه: بیمارمحوری, مراقبت, بیمارستان,
چکیده مقاله :
مقدمه: مطالعات نشان میدهد که بیش از پنجاه درصد بیماران، اطلاعات روشنی درباره خدمات درمانی خودشان دریافت نمیکنند و در نتیجه، درمان آنها با مشارکت خودشان انجام نمیپذیرد. این مقاله به دلیل اهمیت روزافزون مراقبتهای بیمارمحور در نظام سلامت با هدف بررسی و شناخت آن در بیمارستانها نوشته شد. روش پژوهش: پژوهش حاضر مطالعهای مروری است که از طریق جستجو در منابع علمیمعتبر از جمله Springer ،Elsevier ،Pubmed و سایر منابع اطلاعاتی فارسی نظیر Magiran و SID بین سالهای 2010 تا 2018 انجام گرفته است. برای جستجو در منابع انگلیسی مذکور از کلید واژههایی چون Patient-Centered Care و Patient Centredness و برای جستجو در منابع فارسی از کلید واژههایی همچون مراقبت بیمارمحور و ارتباط پزشک و بیمار استفاده شد. یافتهها: بیمارمحوری دارای تعاریف متفاوتی بوده تمرکز مراقبتهای درمانی را از بیماری به سمت بیمار سوق میدهد. لذا ارائه خدمات سلامت از یک الگوی پزشک سالارانه سنتی که در آن پزشک بهتر از همه میداند به یک روش مراقبتی بیمارمحور در حال تغییر است. هدف اصلی بیمارمحوری، مشارکت بیماران و خانواده آنها در ارائه خدمات میباشد. نتیجهگیری: در نظام سلامت بیمارمحور به جای تمرکز بر تصمیم و اولویتهای پزشک، بر روی نیازها و نگرانیهای شخص بیمار متمرکز میشوند و در این راستا مراکز بیمارستانی باید برنامههایی برای افزایش مشارکت بیماران در روند درمانی اجرا کنند تا علاوه بر افزایش رضایت بیماران، نتایج درمانی بهتری حاصل شود.
Introduction: Research shows that more than 50% of patients do not receive clear information about their own healthcare services and consequently their treatment is not performed with their own participation. The present study was conducted aiming at investigating and recognizing patient-centered care in hospitals for its increasing significance in the health system. Methods: The research is a review study conducted through a search of reputable scientific databases such as Springer, Elsevier, Pubmed as well as Persian databases such as Magiran and SID between 2010 and 2018. Key terms such as “Patient-Centered Care” and “Patient Centredness” were used to search the English databases, and to search in Persian databases, key terms such as "Patient-focused care "and" Relationship between doctor and patient "were employed. Results: The patient-centeredness has different definitions, leading the focus of treatment from illness to patients. Therefore, providing health services is based on a traditional physician-centered model, in which the physician knows best, is changing to a patient-centered healthcare approach. The main goal of the patient-oriented approach is the participation of patients and their families in providing services. Conclusion: In a patient-centered health system, instead of focusing on the physicians’ decisions and priorities, the focus is on the patients’ needs and concerns, and in this regard, the healthcare centers should implement programs to increase the patients’ participation in the therapeutic process so that in addition to increasing patient satisfaction, better therapeutic results can be achieved.
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2- Faghihipour J, Fooladvand F, Ramezanpour Nargesi G .Human Capital Management in Nursing (Vol. 2). Tehran, Iran: Darolfonoon; 2018: 707-66. [Persian]
3- Vosough Taghi Dizaj A, Baniasadi A, Ezabadi Z, Kermani B. The Effect of Quality System Management on Patient Centeredness in an Infertility Care Center. Shefaye Khatam., 2015; 3 (S1): 53-62. [Persian]
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15- Kreindler SA. The politics of patient‐centred care. Health Expectations, 2015 Oct; 18(5): 1139-50.
16- Esmaeili M, Cheraghi MA, Salsali M. Barriers to patient‐centered care: A thematic analysis study. International Journal of Nursing Knowledge, 2014 Feb 1; 25(1): 2-8.
17- Lüdecke D. Patient centredness in integrated care: results of a qualitative study based on a systems theoretical framework. International journal of integrated care, 2014 Nov 6; 14(4): 1.
18- Picker Institute. Picker Principles. 2013 [1]; Available at: http://pickerinstitute.org/about/picker-principles/on. July 12, 2018.
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22- Hashjin AA, Kringos DS, Manoochehri J, Ravaghi H, Klazinga NS. Implementation of patient safety and patient-centeredness strategies in Iranian hospitals. PloS one, 2014 Sep 30; 9(9): 1.
23- Masoudiasl I, Nasiri T, Dopeykar N, Shams L. Observance of the Patient-Oriented Standards of Joint Commission International and Its Relation to Attracting Of Health Tourists in Selected Hospitals in Tehran, Iran. Journal of Payavard Salamat, 2015 Jul 15; 9(2):192-202. [Persian]
24- Farnia F, Fooladi L, Nasiriani Kh, Lotfi MH. Effectiveness of Family-Centered Care on Family Satisfaction in Intensive Care Units. Hakim Health Sys Res, 2015; 17(4): 306- 12. [Persian]
25- Abbasi S, Tavakoli N, Moslehi M. Readiness of hospitals with quality management systems based on Joint Commission on accreditation standards. Health Information Management, 2012; 9(4): 512. [Persian]
26- Kane PM, Murtagh FE, Ryan K, Mahon NG, McAdam B, McQuillan R, et al. The gap between policy and practice: a systematic review of patient-centred care interventions in chronic heart failure. Heart failure reviews, 2015 Nov 1; 20(6): 673-87.
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_||_1- Sadaghiani E .Hospital Organization and Management (Vol. 1). Tehran, Iran: Jahan Rayaneh; 2016: 351-55. [Persian]
2- Faghihipour J, Fooladvand F, Ramezanpour Nargesi G .Human Capital Management in Nursing (Vol. 2). Tehran, Iran: Darolfonoon; 2018: 707-66. [Persian]
3- Vosough Taghi Dizaj A, Baniasadi A, Ezabadi Z, Kermani B. The Effect of Quality System Management on Patient Centeredness in an Infertility Care Center. Shefaye Khatam., 2015; 3 (S1): 53-62. [Persian]
4- Houshmand E, Ebrahimipour H, Doosti H, Vafaei NA, Mahmoudian P, Hosseini SE. Validity and reliability of the Persian version of quality assessment questionnaire (SERVUSE model). Payesh, 2016; 5: 515-22. [Persian]
5- Hojjati H .Principles and Theories of Management and its Application in Nursing .Tehran, Iran:Jameenegar; 2018: 1-6. [Persian]
6- Moin A, Anbari Akmal K. The Patient-Physician Communication. Daneshvar Medicine, 2010; 17 (85): 71-80. [Persian]
7- Nasr A. What is patient-centered healthcare? 2016; [1]. Available at: https://meidaan.com/archive/20567. July 5, 2018. [Persian]
8- Delaney LJ. Patient-centred care as an approach to improving health care in Australia. Collegian, 2018 Feb 1; 25(1): 119-23.
9- Arab M, Hamouzadeh P, Yousefvand M, Namani F, Abdi M. Comparison of Patient-Centered Situation in Selected Hospitals Affiliated to Tehran University of Medical Sciences from the Viewpoint of Nurses and Patients. Journal of Hospital, 2016 Aug 15; 15(3): 31-9. [Persian]
10- Dehnavi H. The participation of patients in their services is low. 2015; [2]. Available at: http://healthcareimprovement.ir. July 2, 2018. [Persian]
11- Guastello S. HALE M. Patient-centered communication strategies: Shifting from communicating to patients to communicating with them. Northern Westchester Hospital. Article for Case in Point, 2014 June; 1.
12- Stojan JN, Clay MA, Lypson ML. Assessing patient-centred care through direct observation of clinical encounters. BMJ Quality & Safety Online First, 2015 Sep; 1.
13- Constand MK, MacDermid JC, Dal Bello-Haas V, Law M. Scoping review of patient-centered care approaches in healthcare. BMC health services research, 2014 Dec; 14(1): 271.
14- Wilkerson L, Fung CC, May W, Elliott D. Assessing patient-centered care: one approach to health disparities education. Journal of general internal medicine, 2010 May 1; 25(2): 86-90.
15- Kreindler SA. The politics of patient‐centred care. Health Expectations, 2015 Oct; 18(5): 1139-50.
16- Esmaeili M, Cheraghi MA, Salsali M. Barriers to patient‐centered care: A thematic analysis study. International Journal of Nursing Knowledge, 2014 Feb 1; 25(1): 2-8.
17- Lüdecke D. Patient centredness in integrated care: results of a qualitative study based on a systems theoretical framework. International journal of integrated care, 2014 Nov 6; 14(4): 1.
18- Picker Institute. Picker Principles. 2013 [1]; Available at: http://pickerinstitute.org/about/picker-principles/on. July 12, 2018.
19- Dehghan nayeri N, Salehi T .Principles of Nursing Management. Tehran, Iran: Bashari; 2010: 103. [Persian]
20- WHO Regional office for Europe .Health 2019, A European policy framework and strategy for the st century. Copenhagen, Denmark: Publications
WHO Regional Office for Europe; 2013: 106.
21- Bahrami M, Dehghani S, Eghbali M, Darya Beigi R. The effect of a communicative - educative program on patients’ satisfaction from pain management following cancer surgery. Medical Ethics Journal, 2015; 8(26): 47-67. [Persian]
22- Hashjin AA, Kringos DS, Manoochehri J, Ravaghi H, Klazinga NS. Implementation of patient safety and patient-centeredness strategies in Iranian hospitals. PloS one, 2014 Sep 30; 9(9): 1.
23- Masoudiasl I, Nasiri T, Dopeykar N, Shams L. Observance of the Patient-Oriented Standards of Joint Commission International and Its Relation to Attracting Of Health Tourists in Selected Hospitals in Tehran, Iran. Journal of Payavard Salamat, 2015 Jul 15; 9(2):192-202. [Persian]
24- Farnia F, Fooladi L, Nasiriani Kh, Lotfi MH. Effectiveness of Family-Centered Care on Family Satisfaction in Intensive Care Units. Hakim Health Sys Res, 2015; 17(4): 306- 12. [Persian]
25- Abbasi S, Tavakoli N, Moslehi M. Readiness of hospitals with quality management systems based on Joint Commission on accreditation standards. Health Information Management, 2012; 9(4): 512. [Persian]
26- Kane PM, Murtagh FE, Ryan K, Mahon NG, McAdam B, McQuillan R, et al. The gap between policy and practice: a systematic review of patient-centred care interventions in chronic heart failure. Heart failure reviews, 2015 Nov 1; 20(6): 673-87.
27- Alavizade M, Nasiripour AA, Jadidi R. The Relationship between Patient-Centered Care and Health Outcomes in a Hospital: Tehran. ndhj.lums.ac.ir 3, 2016; 7 (2): 17-25. [Persian]
28- Foley H, Steel A. Patient perceptions of patient-centred care, empathy and empowerment in complementary medicine clinical practice: A cross-sectional study. Advances in integrative medicine, 2017 Apr 1; 4(1): 22-30.