Asadi-Lari Mohsen, Packham Chris, Gray David
Division of Cardiovascular Medicine, University Hospital, Nottingham, NG7 2UH, UK.
Health Qual Life Outcomes. 2003 Oct 22;1:57. doi: 10.1186/1477-7525-1-57.
To assess satisfaction of survivors of coronary artery diseases (CAD) with healthcare services and to determine whether specific components of standard health-related quality of life (HRQL) assessment tools might identify areas of satisfaction and dissatisfaction.
A specific tool developed to provide a comprehensive assessment of healthcare needs was administered concomitantly with generic and specific HRQL instruments, on 242 patients with CAD, admitted to an acute coronary unit during a single year.
92.5% of patients confirmed their trust in and satisfaction with the care given by their General Practitioner; even so, one third experienced difficulty getting an appointment and a quarter wanted more time for each consultation or prompt referral to a specialist when needed. Around a third expressed dissatisfaction with advice from the practice nurse or hospital consultant. Overall 54% were highly satisfied with services, 33% moderately satisfied and 13% dissatisfied. Cronbach's alpha was 0.87; the corrected total-item correlation ranged between 0.55-0.75, with trivial 'floor' score and low 'ceiling' effect. Several domains in all three HRQL tools correlated with items relating to satisfaction. The Seattle Angina Questionnaire Treatment Score correlated significantly with all satisfaction items and with the global satisfaction score.
Cardiac patients' demanded better services and advice from, and more time with, health professionals and easier surgery access. The satisfaction tool showed acceptable psychometric properties. In this patient group, disease-specific HRQL tools seem more appropriate than generic tools for surveys of patient satisfaction.
评估冠状动脉疾病(CAD)幸存者对医疗服务的满意度,并确定标准健康相关生活质量(HRQL)评估工具的特定组成部分是否能识别出满意和不满意的领域。
在一年中,对入住急性冠状动脉病房的242例CAD患者,同时使用一种专门开发用于全面评估医疗需求的工具以及通用和特定的HRQL工具。
92.5%的患者确认他们信任并满意其全科医生提供的护理;即便如此,三分之一的患者在预约时遇到困难,四分之一的患者希望每次咨询有更多时间,或在需要时能迅速转诊至专科医生。约三分之一的患者对执业护士或医院顾问的建议表示不满。总体而言,54%的患者对服务高度满意,33%的患者中度满意,13%的患者不满意。克朗巴哈系数为0.87;校正后的总项目相关性在0.55 - 0.75之间,“地板”分数微不足道,“天花板”效应较低。所有三种HRQL工具中的几个领域与满意度相关项目存在相关性。西雅图心绞痛问卷治疗得分与所有满意度项目以及总体满意度得分均显著相关。
心脏病患者要求从医疗专业人员那里获得更好的服务和建议,有更多时间与他们交流,并且手术更便捷。该满意度工具显示出可接受的心理测量特性。在这个患者群体中,针对特定疾病的HRQL工具在患者满意度调查中似乎比通用工具更合适。