Magaret Nathan D, Clark Thomas A, Warden Craig R, Magnusson A Roy, Hedges Jerris R
Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098, USA.
Acad Emerg Med. 2002 Dec;9(12):1379-88. doi: 10.1197/aemj.9.12.1379.
To assess and compare overall satisfaction in pediatric emergency department (ED) patients and their accompanying parents. To identify aspects of health care delivery that influence satisfaction in these groups.
Pediatric patients (ages 5-17 years) and their parents (or guardians) seen at a university hospital pediatric ED were eligible. A convenience sample of English-speaking subject pairs (n = 101 pairs) was enrolled. Questionnaires were administered to both children and their parents at the completion of their ED care. The survey instruments used a modified Wong-Baker FACES Pain Rating Scale and a six-point interval scale. Factors measured included overall satisfaction, perceptions of pain and fear, and other characteristics of the ED visit. Data were analyzed using paired Wilcoxon signed-rank tests, Spearman rank correlation coefficients, and Fischer's exact chi-square tests (alpha = 0.05) where appropriate.
Parent satisfaction was associated with the quality of provider-patient interactions (R = 0.54, p = 0.0001), the adequacy of information provided (R = 0.47, p = 0.0001), and shorter waiting room times (R = -0.24, p = 0.01). Child satisfaction was associated with the quality of provider-patient interactions (R = 0.24, p 0.04), adequacy of information provided (R = 0.51, p = 0.003), and resolution of pain (R = 0.25, p = 0.03). Parent estimates were similar to children's initial pain scores; however, children reported greater resolution of pain than appreciated by their parents (p = 0.006).
Satisfaction can be validly and reliably measured in pediatric patients using a visual scale instrument. Factors that influence patient satisfaction were similar among both children and their parents. The influence of pain resolution on pediatric ED satisfaction is a novel finding, which demonstrates the importance of appropriate pain and anxiety assessment and treatment in children.
评估并比较儿科急诊科（ED）患者及其陪同家长的总体满意度。确定影响这些群体满意度的医疗服务提供方面。
在大学医院儿科急诊科就诊的儿科患者（5至17岁）及其家长（或监护人）符合条件。招募了一个说英语的受试者对便利样本（n = 101对）。在急诊科护理结束时，向儿童及其家长发放问卷。调查工具使用了改良的Wong-Baker面部表情疼痛评分量表和六点间隔量表。测量的因素包括总体满意度、疼痛和恐惧感知以及急诊就诊的其他特征。在适当情况下，使用配对Wilcoxon符号秩检验、Spearman秩相关系数和Fischer精确卡方检验（α = 0.05）对数据进行分析。
家长满意度与医患互动质量（R = 0.54，p = 0.0001）、提供信息的充分性（R = 0.47，p = 0.0001）以及较短的候诊时间（R = -0.24，p = 0.01）相关。儿童满意度与医患互动质量（R = 0.24，p < 0.04）、提供信息的充分性（R = 0.51，p = 0.003）以及疼痛缓解情况（R = 0.25，p = 0.03）相关。家长的估计与儿童最初的疼痛评分相似；然而，儿童报告的疼痛缓解程度高于家长的感知（p = 0.006）。
使用视觉量表工具可以有效且可靠地测量儿科患者的满意度。影响患者满意度的因素在儿童及其家长中相似。疼痛缓解对儿科急诊科满意度的影响是一项新发现，这表明对儿童进行适当的疼痛和焦虑评估及治疗很重要。
