McEvoy Bernard, Nydegger Rudy, Williams George
Albany Medical College, Albany, New York, USA.
Int J Dermatol. 2003 Apr;42(4):274-80. doi: 10.1046/j.1365-4362.2003.01611.x.
Missed appointments are a major problem in healthcare delivery, and are one element of patient compliance with treatment.
To determine whether there was a relationship between the beliefs, attitudes, expectations of treatment, and previous treatment experiences of acne patients and the keeping of follow-up appointments for treatment.
One hundred and forty-four consecutive patients presenting to a private dermatologist's office for the treatment of acne completed questionnaires concerning their beliefs and previous treatment, and a record was maintained of missed appointments over a series of five scheduled appointments. A control group of middle and high school students completed the same pretreatment questionnaire. Six months after starting treatment, a second questionnaire was completed regarding compliance with treatment, problems with medication, and frequency of appointments and appointment keeping.
There were very few differences between patients and controls in beliefs about the cause and treatment of acne. Patient appointment keeping was as follows: 28% of acne patients attended all four follow-up appointments, 10% three follow-up appointments, 15% two follow-up appointments, 13% one follow-up appointment, and 19% no follow-up appointments. Fifteen per cent of patients dropped out of treatment for one or two appointments and then returned.
Demographic factors, such as gender, race, method of payment for medical services, and type of therapy prescribed, were more important in determining appointment keeping behavior than were patient attitudes and beliefs, previous therapy, or severity of acne. Although there was no correlation between appointment keeping and knowledge of the condition, knowledge of the medication, severity of acne, age, or previous medical treatment, relationships were observed between demographic factors and appointment keeping.
失约是医疗服务中的一个主要问题,也是患者治疗依从性的一个方面。
确定痤疮患者的信念、态度、治疗期望、既往治疗经历与坚持后续治疗预约之间是否存在关联。
连续144例到私立皮肤科医生办公室治疗痤疮的患者完成了关于其信念和既往治疗的问卷,并记录了一系列五次预约中的失约情况。一组中学生和高中生作为对照组完成了相同的治疗前问卷。开始治疗六个月后,完成了第二份问卷,内容涉及治疗依从性、用药问题、预约频率和预约遵守情况。
患者和对照组在痤疮病因和治疗的信念方面差异很小。患者的预约遵守情况如下:28%的痤疮患者参加了所有四次后续预约,10%参加了三次后续预约,15%参加了两次后续预约,13%参加了一次后续预约,19%未参加任何后续预约。15%的患者因一两次预约未参加而退出治疗,之后又回来。
在决定预约遵守行为方面,人口统计学因素,如性别、种族、医疗服务付费方式和所开治疗类型,比患者态度和信念、既往治疗或痤疮严重程度更为重要。虽然预约遵守情况与病情知晓度、药物知识、痤疮严重程度、年龄或既往治疗之间没有相关性,但观察到人口统计学因素与预约遵守情况之间存在关联。