Zebiene Egle, Kairys Jonas, Zokas Ignas
Faculty of Medicine, Vilnius University, Lithuania.
Medicina (Kaunas). 2004;40(5):467-74.
Most of the patients, coming to see their primary care physician, have explicit expectations and priorities for the medical consultation. Recognition of these expectations is an important step in organizing patient-oriented health care services. Patient expectations depend on a number of factors: health problem and its severity, as well as social and demographic characteristics of patient and physician. Objective of this survey was to evaluate influence of patient's socio-demographic characteristics and some health status indicators on expectations for primary care consultation.
During the study 403 patients and 162 physicians were surveyed. Pre-visit expectations of patients coming to see their primary care physician for health problem were investigated using self-addressed original questionnaire.
Factor analysis revealed three main factors: biomedical expectations, emotional support expectations and expectations for partnership. Analysis of influence of socio-demographic characteristics on patient expectations showed that statistically significant differences in different age groups were found only for emotional support factor. Patients' desire for emotional support from doctor increased with age. Relationship was observed between expectations for emotional support and health status as perceived by patient. Patients evaluating their health problem as not serious had mean score of expectations for emotional support 3.4, patients with moderate health problem--3.5, patients with serious health problem--4.0 out of 5.
Patient's need for emotional support from physician depends on his age, marital status, frequency of his visits to physician during the year, self-perception of the health status and course of disease. Analysis of relationship between patient's expectations and his sex, education, physician's sex or type of practice did not show statistically significant differences between groups. No influence of analyzed social and demographic characteristics or perceived health status on biomedical expectations (laboratory tests, specialist consultations, and hospital treatment) was found during our study.
大多数前来就诊于初级保健医生的患者,对医疗咨询有明确的期望和优先事项。认识到这些期望是组织以患者为导向的医疗服务的重要一步。患者的期望取决于多种因素:健康问题及其严重程度,以及患者和医生的社会人口特征。本次调查的目的是评估患者的社会人口特征和一些健康状况指标对初级保健咨询期望的影响。
在研究期间,对403名患者和162名医生进行了调查。使用自填式原始问卷调查了因健康问题前来就诊于初级保健医生的患者就诊前的期望。
因子分析揭示了三个主要因素:生物医学期望、情感支持期望和伙伴关系期望。社会人口特征对患者期望影响的分析表明,仅在情感支持因素上不同年龄组存在统计学显著差异。患者对医生情感支持的渴望随年龄增长而增加。观察到情感支持期望与患者感知的健康状况之间存在关联。将自身健康问题评估为不严重的患者,情感支持期望的平均得分在5分制中为3.4分,健康问题中等的患者为3.5分,健康问题严重的患者为4.0分。
患者对医生情感支持的需求取决于其年龄、婚姻状况、一年中就诊医生的频率、对健康状况的自我认知以及疾病进程。患者期望与性别、教育程度、医生性别或执业类型之间的关系分析未显示出组间存在统计学显著差异。在我们的研究中,未发现所分析的社会人口特征或感知的健康状况对生物医学期望(实验室检查、专科会诊和住院治疗)有影响。