Ajayi I O, Olumide E A, Oyediran O
Department of General Outpatients' Clinic, University College Hospital, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Afr J Med Med Sci. 2005 Jun;34(2):133-40.
Patient-based assessments of medical care are increasingly being used to measure the quality of health care. A variety of methods - qualitative and quantitative - are available. However, patient satisfaction surveys are frequently used. Triangulation of methods increases both the validity and reliability of data. This study assessed patients' perception of care provided at an outpatient clinic using triangulation of methods. No evaluation of care provided at this clinic has been carried out since established. Four hundred and seven adult patients selected by systematic sampling technique were interviewed, 10 focus group discussion sessions (FGD) were held and observations were made at the record clerks' desk, nurses' desk and waiting hall. Also, 35 consultations were observed. Generally, all methods revealed high level of satisfaction with the different aspects of care assessed. However, assessment of satisfaction using survey method concealed a variety of negative experiences reported at FGD and observation. These discrepancies were related to satisfaction with the organization of the clinic, attitude of record clerks' and consultation process. The study provided valuable information to assist in improving the quality of care at the clinic; specifically, the long waiting time, attitude of the record clerks, the dearth of basic amenities, deficient patient-doctor communication skills and health promotion services.
基于患者的医疗评估越来越多地被用于衡量医疗保健的质量。有多种方法可供使用——定性和定量的。然而,患者满意度调查经常被采用。方法的三角测量增加了数据的有效性和可靠性。本研究采用方法三角测量法评估了门诊患者对所提供护理的看法。自该诊所成立以来,尚未对其提供的护理进行过评估。通过系统抽样技术选取了407名成年患者进行访谈,举行了10次焦点小组讨论会议,并在记录员办公桌、护士办公桌和候诊厅进行了观察。此外,还观察了35次会诊。总体而言,所有方法都显示出对所评估护理的不同方面高度满意。然而,使用调查方法评估满意度掩盖了焦点小组讨论和观察中报告的各种负面经历。这些差异与对诊所组织、记录员态度和会诊过程的满意度有关。该研究提供了有价值的信息,以帮助提高诊所的护理质量;具体而言,包括漫长的等待时间、记录员的态度、基本设施的匮乏、医患沟通技巧的不足以及健康促进服务。