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Article(id=1322168498936197779, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168329855418548, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.07.025, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750694400000, receivedDateStr=2025-06-24, revisedDate=1772380800000, revisedDateStr=2026-03-02, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159134849, onlineDateStr=2026-10-28, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159134849, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159134849, creator=13701087609, updateTime=1793159134849, updator=13701087609, issue=Issue{id=1322168329855418548, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='7', pageStart='1057', pageEnd='1240', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159094536, creator='13701087609', updateTime=1793159094536, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1237, endPage=1240, ext={EN=ArticleExt(id=1322168499133330068, articleId=1322168498936197779, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application status quo on patient versions of guidelines in health education, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This study systematically reviewed the practice of patient versions of guidelines(PVGs) in health education both domestically and internationally,analyzed the application status quo and core challenges of PVGs in health education,and to propose feasible optimization strategies based on international practice and localization experience,in order to provide theoretical support and practical reference for the high-quality development of PVGs and the construction of the health education system in China.

, authors=Qianying ZHAO1, Yan YU1, Pengjie SHA1, Rongrong WANG2, Xinfeng GUO2, Lihong YANG2, authorsList=Qianying ZHAO, Yan YU, Pengjie SHA, Rongrong WANG, Xinfeng GUO, Lihong YANG, authorCompany=null, correspAuthors=Xinfeng GUO, authorNote=null, correspAuthorsNote=
GUO Xinfeng, E-mail:
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系统梳理国内外患者版指南（PVGs）在健康教育中的实践，分析患者版指南在健康教育中的应用现状及核心挑战，并基于国际实践与本土化经验提出可行的优化策略，以期为我国患者版指南高质量发展及健康教育体系建设提供理论支持与实践参考。

, authors=赵倩滢1, 余艳1, 沙鹏杰1, 王荣荣2, 郭新峰2, *, *, 杨丽虹2, authorsList=赵倩滢, 余艳, 沙鹏杰, 王荣荣, 郭新峰, 杨丽虹, authorCompany=null, correspAuthors=郭新峰, authorNote=

赵倩滢，硕士研究生在读

, correspAuthorsNote=
郭新峰，E-mail：
GUO Xinfeng, E-mail:
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Comparison of two compilation methods for patient versions of guidelines

, figureFileSmall=null, figureFileBig=null, tableContent=
项目传统编制以患者需求为导向的重新编制
满足患者个性化需求否是
基于现有指南是否
语言通俗易懂是是
针对具体疾病设计是是
科学和权威是是
适合快速推广是否
), ArticleFig(id=1322530385649578293, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168498936197779, language=CN, label=表1, caption=

患者版指南2种编制方式比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目传统编制以患者需求为导向的重新编制
满足患者个性化需求否是
基于现有指南是否
语言通俗易懂是是
针对具体疾病设计是是
科学和权威是是
适合快速推广是否
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患者版指南在健康教育中的应用现状
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赵倩滢 1 , 余艳 1 , 沙鹏杰 1 , 王荣荣 2 , 郭新峰 2, *, * , 杨丽虹 2
护理研究 | 科研综述 2026,40(7): 1237-1240
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护理研究 |科研综述 2026 , 40 (7) : 1237 -1240
患者版指南在健康教育中的应用现状
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赵倩滢1, 余艳1, 沙鹏杰1, 王荣荣2, 郭新峰2, *, * , 杨丽虹2
作者信息
  • 1广州中医药大学第二临床医学院，广东 510405
  • 2广东省中医院
通讯作者:
郭新峰，E-mail：
GUO Xinfeng, E-mail:
作者简介:

赵倩滢，硕士研究生在读

Application status quo on patient versions of guidelines in health education
Qianying ZHAO1, Yan YU1, Pengjie SHA1, Rongrong WANG2, Xinfeng GUO2 , Lihong YANG2
Affiliations
  • 1The Second Clinical Medical School, Guangzhou University of Chinese Medicine, Guangdong 510405 China
  • 2Guangdong Provincial Hospital of Traditional Chinese Medicine
    • Corresponding Author:
    GUO Xinfeng, E-mail:
出版时间: 2026-04-10 doi: 10.12102/j.issn.1009-6493.2026.07.025
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摘要
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系统梳理国内外患者版指南（PVGs）在健康教育中的实践，分析患者版指南在健康教育中的应用现状及核心挑战，并基于国际实践与本土化经验提出可行的优化策略，以期为我国患者版指南高质量发展及健康教育体系建设提供理论支持与实践参考。

患者版指南  /  健康教育  /  应用现状  /  综述

This study systematically reviewed the practice of patient versions of guidelines(PVGs) in health education both domestically and internationally,analyzed the application status quo and core challenges of PVGs in health education,and to propose feasible optimization strategies based on international practice and localization experience,in order to provide theoretical support and practical reference for the high-quality development of PVGs and the construction of the health education system in China.

patient versions of guidelines  /  health education  /  application status quo  /  review
赵倩滢, 余艳, 沙鹏杰, 王荣荣, 郭新峰, 杨丽虹. 患者版指南在健康教育中的应用现状. 护理研究, 2026 , 40 (7) : 1237 -1240 . DOI: 10.12102/j.issn.1009-6493.2026.07.025
Qianying ZHAO, Yan YU, Pengjie SHA, Rongrong WANG, Xinfeng GUO, Lihong YANG. Application status quo on patient versions of guidelines in health education[J]. Chinese Nursing Research, 2026 , 40 (7) : 1237 -1240 . DOI: 10.12102/j.issn.1009-6493.2026.07.025
正文
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患者版指南（patient versions of guidelines，PVGs）是在循证医学理念指导下，由面向医疗专业人员的临床实践指南（clinical practice guidelines，CPGs）转化而来的，便于患者理解和应用的健康信息工具[1]，被认为是连接“最佳证据”与“患者行为”的最优路径。20世纪80年代，患者版指南在欧美兴起[2]，进入21世纪，美国、英国和德国等国家已将患者版指南纳入国家健康教育战略，并在门诊宣教、慢性病随访、康复护理及药物安全教育等典型场景中加以应用，形成了较为成熟的实践模式[3]。我国患者版指南虽然起步较晚，但在“健康中国”的战略背景下，患者版指南在健康教育中的应用价值和推广的必要性愈发凸显。面对我国人口基数大、健康素养区域差异显著、医患共同决策需求迫切等国情，高质量患者版指南被视为提升健康教育效果、弥合医患信息鸿沟的关键工具，但在开发与应用的标准化流程与质量评估、传播路径与更新、资源配置等方面仍存在诸多问题。不仅影响患者版指南的临床应用质量，也阻碍了其在健康教育体系中的深度整合。本研究拟通过系统梳理国内外患者版指南在健康教育领域的应用现状与问题，并基于国际实践与本土化经验提出可行的优化策略，以期为我国患者版指南高质量发展及健康教育体系的建设提供理论支持与实践参考。
1　患者版指南的发展概况
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患者版指南以患者需求为中心，将循证证据转化为通俗易懂、可操作的健康教育工具，突出信息传播与决策支持的双重价值。
1.1　患者版指南的制作流程与编制方式
患者版指南的编制通常包括需求评估、循证检索与评价、文本编写、用户测试与反馈、专家评审及动态更新六大环节[4]。国内的患者版指南仍以翻译和简化专业指南为主。国际实践则强调多学科协作与患者深度参与，通过简明语言、图文结合及多媒体形式提高信息的可理解性与可操作性[5]。目前，患者版指南主要有2种编制模式：一是，在制定专业指南的同时开展患者版指南的制定，针对专业指南内容，降低专业术语门槛，提升文本的可读性和易用性[6]。其优势在于开发效率高、便于快速推广。二是，以患者需求为导向，广泛收集患者关注的临床问题进行重新设计和编制。此模式更聚焦患者在疾病管理过程中的实际问题（如症状监测、用药说明、术后护理等）[7]，因而内容的针对性和实用性通常更强。研究显示，不同编制模式的选择及其执行质量将直接影响患者版指南在健康教育等领域的应用效果。与第1种编制模式相比，需求导向型编制模式能够更好地结合患者反馈，精准对接不同群体在疾病管理中的现实困惑和信息空白，进而显著提升患者的依从性和指南在健康教育中的实际转化价值。详见表1。
1.2　患者版指南发展历程
2012年，国际指南协作网（Guidelines International Network，GIN）[8]发布《患者指南制定框架》，标志着患者版指南进入方法学标准化阶段。随后，英国国家卫生与临床优化研究所（NICE）、美国预防服务特别工作组（USPSTF）、澳大利亚国家卫生与医学研究理事会（NHMRC）等相继建立了较为完善的编写规范、评估标准和患者参与机制，推动了患者版指南的规范化发展。其中，德国实现了患者代表全程参与指南的开发流程[9]。近年来，随着人工智能、大数据和可视化技术的应用，欧美及澳大利亚等国家积极探索患者版指南与患者决策辅助工具及数字健康产品的融合[10]，在个性化推荐、实时更新和交互式呈现等方面展现出新的发展趋势。目前，我国患者版指南整体仍处于由试点探索向系统化发展的过渡阶段。早期颁布的《肝病患者康复指南》[11]、《糖尿病患者运动指南》[12]等指南，多基于专家经验编制。随着循证医学的引入，患者版指南的开发模式逐步向证据驱动转变，并相继颁布了《中国高血压患者教育指南》[13]、《中国乳腺癌患者生活方式指南》[14]等具有代表性的成果，在慢性病管理和生活方式干预等领域积累了初步经验。但我国的患者版指南仍存在低文化群体理解障碍、指南简化致信息失真、医患信息与决策权分配不均衡三大差距[15]，难以满足多样化的传播和使用需求。
上述差距在具体实践中进一步表现为内在局限：1）现有患者版指南在设计上表现为语言表层简化，缺乏分层呈现与情境化演练，因而在低文化群体中易导致理解障碍和应用困难[16-17]。这种“一刀切式”的简化虽然在一定程度上降低了阅读门槛，但并未真正解决低健康素养群体“可理解”与“用得上”的双重需求。结果导致这部分群体在面对饮食、运动或用药等具体行为建议时，往往停留在模糊理解层面，难以将抽象表述转化为可操作的日常行为，从而削弱了指南在促进知识理解与实践应用方面的实际效能。2）患者版指南的目标是将复杂的医学证据讲清楚，但在追求易懂的过程中，部分团队采取“删减-替代”的极端简化策略，结果造成关键信息被弱化，甚至缺失[18]。典型表现为药物不良反应提示多局限“常见症状”，而少见但严重的安全风险未被充分呈现；饮食建议仅以“少油少盐”等笼统表述代替，缺乏推荐剂量与证据等级的支撑。此类简化虽表面提升了指南易读性，但削弱了循证性与科学严谨性，降低了权威性，并可能误导患者形成片面的健康认知。3）在我国医疗环境中，医生掌握信息和决策的主导权，患者则多为被动接受者[19]。在这种语境下，患者版指南常被定位为医生的“宣教补充”，而非患者自主学习和参与决策的工具。结果导致患者版指南的自身价值：帮助患者提出问题、理解选项、参与共同决策，并未得到充分发挥，在促进医患互动和提升患者话语权方面的作用被大幅削弱。
2　患者版指南在健康教育中的应用
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2.1　患者版指南在健康教育中的应用范围
患者版指南的应用范围不断拓展，已涵盖多个临床与公共健康领域，其核心价值在于针对不同领域提供个性化的健康教育指导。其主要应用领域涵盖了慢性病管理（如高血压、糖尿病、冠心病）[20]、康复护理（术后、骨科及神经康复）[21]、药物安全教育（长期用药与不良反应监测）[22]、特定人群教育（孕产妇、儿童、老年人及精神疾病患者）[23]以及公共健康（传染病防控、疫苗接种、膳食营养与运动促进）[24]等。在这些领域，患者版指南通过通俗化语言、图文并茂及多媒体形式，逐步嵌入门诊宣教、出院前教育、慢性病随访和康复护理等环节，形成“发放-讲解-复习/随访”的链条化教育路径。
2.2　患者版指南在健康教育中的应用成效
随着互联网和线上医疗的普及，患者对权威医学知识的需求显著增长[25]。然而，网络健康信息质量参差不齐[26]，虚假广告和未经验证的内容充斥其间；同时，居民整体健康素养水平有限[27]；现有部分健康教育工具又存在内容专业性过强、表达晦涩和操作性不足的问题。在此背景下，健康教育亟须权威、通俗且可操作的知识工具弥补信息缺口。患者版指南凭借循证性、通俗化和获取便利性，正好契合这一需求，并在健康教育实践中展现出显著成效。首先，患者版指南提升了患者对健康教育信息的信任度与采纳度[28]。由于多数患者版指南由权威学术机构或国家级组织制定并通过官方网站与学术平台发布，其科学性与可信度得到保证，相关健康教育信息更容易让患者采纳和信任。其次，患者版指南增强了患者对信息获取的便利性。在三级甲等医院、社区卫生服务中心及数字化医疗平台中，患者版指南通过“官网/门户+纸质/PDF+App/公众号/短视频”等多元渠道嵌入门诊、出院指导和随访环节[29]，确保患者在诊疗全过程中均可便利地获取与使用教育材料。再次，患者版指南提升了医学信息的可理解性与可执行性。高质量患者版指南通过通俗化语言、图表、流程图等设计[23]，降低了患者对理解医学信息的难度，并借助情景化案例和细节说明，提供可直接转化为具体行动的指导，从而增强了健康教育内容的实用性与执行力。最后，患者版指南推动了健康教育的覆盖率与公平性。部分国内试点探索方言音频、简化图文手册等适配策略[10]，有效改善了老年人及低文化水平患者的理解与接受度，从而拓展了健康教育的受众覆盖范围，提升了健康教育的公平性。
2.3　患者版指南在健康教育中的不足
尽管患者版指南在健康教育中已展现出积极作用，但其应用仍存在多方面的不足。一是开发与应用的标准化及评估不足[15]。目前，不同机构在患者版指南的开发流程、方法学规范和质量控制上尚未形成统一标准，导致内容质量参差不齐，缺乏可比性及一致性；应用层面也缺乏系统化和长期性的成效评估，对于使用频率、患者反馈以及健康行为改善等关键环节，尚未建立统一的量化标准和跨机构对比体系，使得已有的积极成效难以被充分验证和推广，限制了基于证据的持续优化。二是传播与更新滞后[21]。尽管部分医疗机构已探索通过官方网站、移动应用及新媒体等多元渠道推广患者版指南，但整体更新进度仍存在滞后性，跨机构间缺乏有效的版本协同与信息共享。医务人员和患者难以及时获取最新版本，不仅影响临床推荐的积极性，也削弱了健康教育的应用效果。三是资源配置不均衡[30]。尽管部分试点探索在弱势群体中改善了信息获取的公平性，但整体来看，患者版指南的应用仍主要集中于大型综合医院和经济发达地区。区域差距限制了患者的获取机会，加剧了健康教育资源分布的不均衡。
3　提升患者版指南在健康教育领域应用成效的优化策略
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3.1　推进标准化编制与评估体系建设
建议参考GIN框架与患者版指南报告规范工具（RIGHT-患者版指南）进行本土化改良，制定患者版指南编制与评价规范。结合我国人群的健康素养差异，增加“语言分级标准”（如小学、初中、高中及以上3个理解层级）和“情景化案例要求”（如风俗饮食习惯、城乡差异）。增加语言分级和情境化案例要求，设立量化指标，如可理解性评分、患者使用率[31]、依从性改善率、再入院率下降率。
3.2　完善传播与更新机制
依托国家级健康科普平台与“健康中国”App等，搭建统一发布与推送系统。各学会发布新版患者版指南时必须上传，并与医院信息系统（HIS）系统对接，实现诊断自动匹配、一键打印或二维码推送，例如患者在门诊确诊疾病后系统自动生成二维码，医生可一键打印带回；出院小结、处方笺默认附带最新版患者版指南的二维码链接。平台设立动态更新机制，每2~3年常规修订，重大证据即时更新，并通过短信、微信公众号和社区随访系统向患者推送提醒。为确保弱势群体受益，应提供简版手册、短视频、方言语音包等多形态材料，保证线上线下双轨传播。
3.3　加强基层与欠发达地区的推广
鉴于基层医疗体系和资源环境的不足问题，可在国家继续教育项目中增加患者版指南健康教育技能学分课程，通过线上教育课程+线下培训结合的方式提升基层医务人员的应用能力。针对老年人、低文化水平患者，可开发本土化材料，如大字号图文版教育材料、简化流程卡、双语版/方言语音指南，并结合家庭医生签约服务，在慢性病随访中嵌入患者版指南使用。通过这种模式，不仅能缩小城乡差距，还能在基层逐步建立起患者版指南的使用习惯和依从性。
4　小结
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综上所述，患者版指南作为健康教育的核心工具，已在门诊宣教、慢性病管理和康复指导中发挥了重要作用。然而，其推广仍面临版本管理分散、文化适配不足及基层覆盖有限等现实挑战。未来应加强政策引导与经费支持，构建统一平台与动态更新机制，深化数字化赋能与跨部门协作，优化内容本土化适配与多渠道覆盖，建立患者全程参与机制，提升健康教育的公平性、持续性和适用性，最终促进患者科学决策与有效的自我管理，助力“健康中国”建设目标的实现。

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2026年第40卷第7期
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doi: 10.12102/j.issn.1009-6493.2026.07.025
  • 接收时间：2025-06-24
  • 首发时间：2026-10-28
  • 出版时间：2026-04-10
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  • 收稿日期：2025-06-24
  • 修回日期：2026-03-02
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    1广州中医药大学第二临床医学院，广东 510405
    2广东省中医院

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
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