Trummer Ursula F, Mueller Ulrich O, Nowak Peter, Stidl Thomas, Pelikan Jürgen M
Ludwig Boltzmann Institute for Sociology of Health and Medicine, WHO, Collaborating Center for Health Promotion in Hospitals and Health Care, Vienna, Austria.
Patient Educ Couns. 2006 May;61(2):299-306. doi: 10.1016/j.pec.2005.04.009. Epub 2005 Jun 20.
A case study at the department for heart surgery of an Austrian University Hospital in 2001, examined the outcome of improved communication aimed at empowering patients to be more effective co-producers of recuperation after surgery.
Evaluated were the effects of a training program for developing communication skills of health professionals (physicians, physiotherapists, and nurses) along with a reorganization of patient information schemes. The clinical outcomes after four types of surgery (bypass, stent, artificial valve insertion and combination of these) were observed in 100 patients without (control group) and 99 with the intervention administered (intervention group). Two objective and two subjective health outcome parameters were selected for analysis: care level adjusted length of stay in hospital, frequency of post-surgery complications, subjective health, subjective satisfaction with care received. Self-administered breathing exercises were measured as an intermediary outcome parameter.
In the intervention group length of hospital stay was shorter (by 1 day), incidence of post-surgery tachyarrhythmia was reduced (by 15%), transfer to less intensive care levels was faster and patient ratings for communicative quality of care by doctors and nurses were improved.
Professional communication aimed at empowering patients to act as co producers can indeed have an effect on clinical outcome.
Staff training and reorganization of communication schemes can be an effective intervention in hospital care.
2001年在奥地利一所大学医院的心脏外科进行了一项案例研究，考察了旨在使患者更有效地成为术后康复共同参与者的沟通改善措施的效果。
评估了一项针对卫生专业人员（医生、物理治疗师和护士）沟通技能培养的培训计划以及患者信息方案重组的效果。观察了100例未接受干预（对照组）和99例接受干预（干预组）的患者在四种手术（搭桥、支架、人工瓣膜植入及这些手术的联合）后的临床结果。选择了两个客观和两个主观健康结果参数进行分析：调整后的住院护理水平天数、术后并发症发生率、主观健康状况、对所接受护理的主观满意度。自我管理的呼吸练习作为中间结果参数进行测量。
干预组的住院时间缩短（缩短1天），术后快速心律失常的发生率降低（降低15%），转至较低强度护理水平的速度更快，患者对医生和护士护理沟通质量的评分提高。
旨在使患者成为共同参与者的专业沟通确实会对临床结果产生影响。
员工培训和沟通方案重组可以成为医院护理中的有效干预措施。
