• 作者：Roger Ruiz Moral^a ; ^{roger.ruiz.sspa@juntadeandalucia.es} ; Lucí ; a Peralta Munguia^b ; Luis Á ; ngel Pé ; rula de Torres^c ; Enrique Gavilá ; n Moral^d ; José ; Ramó ; n Loayssa Lara^e
• 关键词：Participació ; n de los pacientes en la toma de decisiones ; Atenció ; n primaria ; Herramientas de medició ; n ; Relació ; n mé ; dico-paciente
• 刊名：Atenci贸n Primaria
• 出版年：2010
• 期刊代码：pca69_02126567
• 类别：med
• 出版时间：May 2010
• 卷：42
• 期：5
• 页码：257-263
• 文件大小：444 K

Objectives

This work aims to explore to what extent Spanish primary care providers involve patients in decisions and describe the development of a suggested tool for assessing patient involvement in these settings.

Design

Cross-sectional, development of a measurement tool.

Setting

Primary care clinics.

Participants

Family doctors and residents.

Interventions

Based on a review of the literature and the opinions of primary care doctors, a selection was made of items from a previous scale used to measure general communication skills (CICAA-Patient Centred) and new specific items were added to this to measure involvement.

Main measurements

The involvement of patients in decision-making was evaluated initially with this tool in 31 different clinical visits and the scale was then reformulated. A pool of 161 interviews was used to complete the process. Some psychometric properties (reliability and internal consistency) were estimated for the different samples and stages of the process.

Results

Some degree of patient involvement was found in just 31 visits. Despite this, only in 18 of these (58%) was there some involvement in a discussion about more than one treatment option. The Cohen's kappa values of the CICAA-Decision scale were between 0.48 and 0.94. Cronbach's alpha was 0.60/0.51. The global Intra-class correlation coefficient was 0.96.

Conclusions

The levels of patient involvement were lower than expected. A simple question, such as that defined by one item in particular, and the CICAA-D scale, in general, could be useful to assess patient involvement in decision making in primary care.