Zebiene E, Razgauskas E, Basys V, Baubiniene A, Gurevicius R, Padaiga Z, Svab I
Vilnius University Medical Faculty, Ciurlionio St. 21, LT-2009 Vilnius, Lithuania.
Int J Qual Health Care. 2004 Feb;16(1):83-9. doi: 10.1093/intqhc/mzh006.
Patient satisfaction with health care services is considered an important factor of health care. Although research on patient satisfaction has become standard in Western Europe, in countries such as Lithuania the concept of patient satisfaction is still a relatively new one. This study aimed to investigate how the meeting of patients' expectations is related to increased satisfaction with medical consultation.
The methodology used by Williams et al. in the UK was applied to the Lithuanian health care setting. Forty physicians from 22 primary health care centres attending courses on general practice at Vilnius University were recruited for the study. Every third adult patient coming to a practice during a 5-day period was invited to participate in the study. In all, 609 patients coming to meet their physician regarding health problems were included in the study sample. The patients were asked to complete three standardized questionnaires: the Patient Intentions Questionnaire prior to the consultation, and the Expectations Met Questionnaire and Medical Interview Satisfaction Scale after the consultation. Cronbach's alpha statistic was used for the validation of the questionnaires and principal components analysis was used to determine the factors of patient expectations.
The response rate was 78%.
of 460 sets of questionnaires revealed that satisfaction with medical consultation is higher among patients who have a greater number of expectations met. Physicians' success in meeting different types of patient expectations also had different influences on patient satisfaction. The most important expectations to be met were "understanding and explanation", followed by expectations of "emotional support", while "getting information" was less important.
The most frequently reported expectations on the Patient Intentions Questionnaire were for "getting information" and "understanding and explanation" of the patients' health problem items, and the least mentioned were for emotional support items. Patients with more expectations met were found to have significantly higher scores on the satisfaction index. Satisfaction with the consultation is best predicted by meeting the patient's expectations for understanding and explanation, and for emotional support. Providing desired information to the patient as well as meeting the patient's expectations for diagnostic procedures and treatment is less associated with patient satisfaction.
患者对医疗服务的满意度被视为医疗保健的一个重要因素。尽管在西欧，对患者满意度的研究已成为标准做法，但在立陶宛等国家，患者满意度的概念仍然相对较新。本研究旨在调查患者期望的达成与医疗咨询满意度提高之间的关系。
将英国威廉姆斯等人使用的方法应用于立陶宛的医疗保健环境。从维尔纽斯大学参加全科医学课程的22个初级医疗保健中心招募了40名医生参与研究。在为期5天的时间里，每第三位前来就诊的成年患者被邀请参与研究。共有609名因健康问题前来就医的患者被纳入研究样本。患者被要求完成三份标准化问卷：咨询前的患者意向问卷，以及咨询后的期望达成问卷和医疗访谈满意度量表。使用克朗巴哈系数统计量来验证问卷，并使用主成分分析来确定患者期望的因素。
回复率为78%。
对460套问卷的分析显示，期望达成数量较多的患者对医疗咨询的满意度更高。医生在满足不同类型患者期望方面的成功对患者满意度也有不同影响。最重要的期望是“理解与解释”，其次是“情感支持”期望，而“获取信息”则不太重要。
患者意向问卷中最常报告的期望是“获取信息”和对患者健康问题项目的“理解与解释”，而最少提及的是情感支持项目。发现期望达成更多的患者在满意度指数上得分显著更高。通过满足患者对理解与解释以及情感支持的期望，能最好地预测对咨询的满意度。向患者提供所需信息以及满足患者对诊断程序和治疗的期望与患者满意度的关联较小。
