Makaryus Amgad N, Friedman Eli A
Department of Medicine, North Shore University Hospital, Manhasset, NY, USA.
Mayo Clin Proc. 2005 Aug;80(8):991-4. doi: 10.4065/80.8.991.
To ascertain whether patients at discharge from a municipal teaching hospital knew their discharge diagnoses, treatment plan (names and purpose of their medications), and common side effects of prescribed medications.
From July to October 1999, we surveyed 47 consecutive patients at discharge from the medical service of a municipal teaching hospital in New York City (Brooklyn, NY). Patients were asked to state either the trade or the generic name(s) of their medication(s), their purpose, and the major side effect(s), as well as their discharge diagnoses. Patients were excluded if they were not oriented to person, place, and time, were unaware of the circumstances surrounding their admission to the hospital, and/or did not speak or understand English.
Of the 47 patients surveyed, 4 were excluded. Of the remaining 43 patients, 12 (27.9%) were able to list all their medications, 16 (37.2%) were able to recount the purpose of all their medications, 6 (14.0%) were able to state the common side effect(s) of all their medications, and 18 (41.9%) were able to state their diagnosis or diagnoses. The mean number of medications prescribed at discharge was 3.89.
Less than half of our study patients were able to list their diagnoses, the name(s) of their medication(s), their purpose, or the major side effect(s). Lacking awareness of these factors affects a patient's ability to comply fully with discharge treatment plans. Whether lack of communication between physician and patient is actually the cause of patient unawareness of discharge Instructions or if this even affects patient outcome requires further study.
确定一家市级教学医院的出院患者是否知晓其出院诊断、治疗方案（所用药物的名称及用途）以及所开药物的常见副作用。
1999年7月至10月，我们对纽约市（纽约布鲁克林）一家市级教学医院内科连续出院的47例患者进行了调查。我们要求患者说出所用药物的商品名或通用名、用药目的、主要副作用以及出院诊断。如果患者意识不清、不知道入院的相关情况和/或不会说或听不懂英语，则将其排除。
在接受调查的47例患者中，4例被排除。在其余43例患者中，12例（27.9%）能够列出所有所用药物，16例（37.2%）能够说出所有药物的用途，6例（14.0%）能够说出所有药物的常见副作用，18例（41.9%）能够说出其诊断。出院时所开药物的平均数量为3.89种。
不到一半的研究患者能够列出其诊断、所用药物名称、用药目的或主要副作用。对这些因素缺乏了解会影响患者完全遵守出院治疗方案的能力。医生与患者之间缺乏沟通是否实际上是患者不了解出院医嘱的原因，或者这是否会影响患者的治疗结果，还需要进一步研究。
