Nerney M P, Chin M H, Jin L, Karrison T G, Walter J, Mulliken R, Miller A, Hayley D C, Friedmann P D
Section of General Internal Medicine, Department of Health Studies, University of Chicago, 5841 South Maryland Avenue, Chicago, IL, USA.
Ann Emerg Med. 2001 Aug;38(2):140-5. doi: 10.1067/mem.2001.114304.
We sought to assess older patients' satisfaction with care in the emergency department and to identify factors associated with global satisfaction with care.
We performed a prospective cohort study of 778 patients 65 years of age and older presenting to an urban academic ED between 1995 and 1996, of whom 79% were black and 63% were female. A baseline survey at presentation to the ED asked for demographic information, medical history, and health-related quality of life information. A follow-up satisfaction survey asked patients to rate the care they received in the ED on a 5-point Likert scale (1=excellent, 5=poor). Overall satisfaction with care, dichotomized into responses of "excellent" versus all others, was the primary dependent variable in our bivariate analyses.
Of respondents, 40% rated their ED care as "excellent." Variables significantly correlated with high satisfaction include having the perception of time spent in the ED as not "too long," having the emergency physicians and nurses clearly answer patients' questions, having a relationship of trust with an ED staff member, being told why tests were done, feeling involved in decisions about care as much as they wanted, having pain addressed fully, having a perception of greater health status, and having fewer comorbid conditions at the time of the ED visit. Results may be applicable only to urban academic EDs and may be limited by time elapsed between ED visits and follow-up surveys.
To improve quality of care for older adults in the ED, physicians should be more attentive to older patients' concerns and questions, recognize and aggressively treat pain, and reduce the patients' perception of a long waiting time.
我们旨在评估老年患者对急诊科护理的满意度，并确定与整体护理满意度相关的因素。
我们对1995年至1996年间前往城市学术性急诊科就诊的778名65岁及以上患者进行了一项前瞻性队列研究，其中79%为黑人，63%为女性。在急诊科就诊时进行的基线调查询问了人口统计学信息、病史和与健康相关的生活质量信息。一项随访满意度调查要求患者根据5点李克特量表（1 = 优秀，5 = 差）对他们在急诊科接受的护理进行评分。在我们的双变量分析中，护理的总体满意度分为“优秀”与其他所有情况，是主要的因变量。
在受访者中，40%将他们在急诊科的护理评为“优秀”。与高满意度显著相关的变量包括认为在急诊科花费的时间“不太长”、急诊医生和护士能清楚回答患者的问题、与急诊科工作人员有信任关系、被告知进行检查的原因、感觉在护理决策中参与程度符合自己的意愿、疼痛得到充分处理、感觉健康状况更好以及在急诊科就诊时合并症较少。结果可能仅适用于城市学术性急诊科，并且可能受到急诊科就诊与随访调查之间时间间隔的限制。
为了提高急诊科老年患者的护理质量，医生应该更加关注老年患者的担忧和问题，识别并积极治疗疼痛，减少患者对长时间等待的感知。
