Ruiz-Moral Roger, Pérula de Torres Luis Angel, Jaramillo-Martin Inmaculada
Córdoba Teaching Unit of Family Medicine, Andalusia Health Service, COGRAMA Group: Spanish Primary Care Research Network (redIAPP), Córdoba, Spain.
J Gen Intern Med. 2007 Jan;22(1):86-91. doi: 10.1007/s11606-007-0113-8.
To know the patients' expectations and the fulfillment of these at family medicine consultations by resident doctors and to assess their effect on some consultation outcomes.
A prospective cohort study.
Patients attending family medicine consultations held by 38 resident doctors: 1,301 eligible patients, 702 filled in all questionnaires.
Before each visit, the patients' expectations about that particular consultation were registered. Right after the visit was over, their perception of several aspects of the communicative interaction with the doctor was measured. Later, patients were interviewed on the phone to know how their expectations had been fulfilled, how satisfied they were about the consultation, how they had followed the doctor's suggestions, if they were going to seek further care for the same cause later, and the evolution of their clinical problem. Logistic regression was the main analysis used.
The most common expectations were the doctor showing interest and listening (30.5%), getting some information about the diagnosis (16.3%), and sharing problems and doubts (11.1%). The rate of main expectations that were met was 76.5%. Satisfaction with the encounter was associated with the clinical evolution [odds ratio (OR) 2.23; confidence interval (CI): 1.32-3.75], and the fulfilling of the patients' main or two main expectations was significantly related to all the measured outcomes (satisfaction OR 3.51, CI: 1.73-7.8; adherence OR 1.80, CI: 1.11-2.92; clinical evolution OR 1.54, CI: 1.01-2.35; and seeking further care later OR 0.54, CI:0.36-0.81)
Patients prioritize expectations of a more general sort when they attend primary care consultations and residents fulfill these acceptably. The fulfillment of expectations seems to affect the studied outcomes more than other factors.
了解患者的期望以及住院医生在家庭医学咨询中对这些期望的满足情况，并评估其对某些咨询结果的影响。
一项前瞻性队列研究。
参加由38名住院医生进行的家庭医学咨询的患者：1301名符合条件的患者，702名填写了所有问卷。
在每次就诊前，记录患者对该次特定咨询的期望。就诊结束后，立即测量他们对与医生沟通互动几个方面的感知。之后，通过电话采访患者，了解他们的期望如何得到满足、对咨询的满意程度、是否遵循了医生的建议、之后是否会因同一原因寻求进一步治疗以及临床问题的进展情况。主要分析方法为逻辑回归。
最常见的期望是医生表现出兴趣并倾听（30.5%）、了解一些诊断信息（16.3%）以及分享问题和疑虑（11.1%）。主要期望得到满足的比例为76.5%。对就诊的满意度与临床进展相关[优势比（OR）2.23；置信区间（CI）：1.32 - 3.75]，患者主要或两个主要期望的满足与所有测量结果显著相关（满意度OR 3.51，CI：1.73 - 7.8；依从性OR 1.80，CI：1.11 - 2.92；临床进展OR 1.54，CI：1.
