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Patient’s Perception of Autonomy Support and Shared Decision Making in Physical Therapy

Open Journal of Preventive Medicine 2015年第9期5卷 387-399页

作者： ignaas devisch Katreine Dierckx Dominique Vandevelde Patricia De Vriendt Myriam Deveugele Department of Primary Care and Family Medicine Ghent University Ghent Belgium Department of Physical Therapy Ghent University Ghent Belgium Free University Brussels Brussels Belgium Artevelde University College Ghent Belgium

Background: Shared Decision Making (SDM) is primarily intended to enhance patient autonomy. To date, the relationship between patients’ perceived levels of involvement and autonomy support has never been investigated in the field of physical therapy. Based on the recently reported extremely low level of observed SDM in physical therapy, similarly poor patient perceptions are expected. Objective: The main objectives of this study were to examine patients’ perceptions of SDM and autonomy support in physical therapy and to explore the relationship between both. Design: Patient survey after real consultations in physical therapy. Methods: Patients completed the Dyadic Observing Patient Involvement (Dyadic OPTION) instrument and the Health Care Climate Questionnaire (HCCQ) to examine patients’ perceived levels of SDM and autonomy support, respectively. Multilevel analyses were applied to determine the relationship between both perceptions. Results: Two hundred and twenty-nine patients, who were recruited by 13 physical therapists, agreed to participate. The median Dyadic OPTION score was 72.9 out of a total possible score of 100. The median HCCQ score was 94.3 out of a total possible score of 100. Patients’ experienced level of SDM (b = 0.14;p < 0.001) and patients’ age (b = 0.12;p = 0.001) contributed to patients’ perceived autonomy support. None of the physical therapist characteristics were related to patients’ perceived autonomy support. Limitations: Only 13 out of 125 therapists who were personally contacted agreed to participate. Conclusion: Using patients’ perceptions, we found that a relationship between SDM and autonomy support existed. In contrast to observational studies, our study also demonstrated that the participating physical therapists individually tailored patient support by adapting their implementation of SDM to each patient.

关键词： Shared Decision Making Autonomy Physical Therapy Patient Autonomy

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Prevention from a community perspective facilitating and constraining factors perceived by nurses in local community health centers in the course of prevention and health promotion

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Open Journal of Preventive Medicine 2012年第4期2卷 461-467页

作者： Bregje D’haeze Wim Peersman Ann Van Hecke ignaas devisch Department of Nursing Sciences Ghent University Ghent Belgium Department of Primary Care Ghent University Ghent Belgium Ghent University and Artevelde University College Ghent Belgium

The purpose of this paper is to explore the stimulating factors and the obstacles experienced by nurses in community health centres in their work with prevention and health promotion. We conducted the qualitative research design consisting of fifteen nurses in five community health centres in Ghent. There was also a focus group and participant observation. All participants experienced stimulating factors as well as obstacles in their work with preventive interventions. The most strongly facilitators were the Electronic Medical File and the multidisciplinary approach. The obstacles mentioned by the nurses were the communication problems and the financial problems. This study may have an important impact on nursing practice and nursing prevention. Further research is needed on nurses working in community health centres and the way they approach their patients in the course of preventive actions.

关键词： Nursing Community Obstacles Stimulating Factors Preventive Health Care

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