Franzén Carin, Björnstig Ulf, Jansson Lilian, Stenlund Hans, Brulin Christine
Department of Nursing, Umeå University, Umeå, Sweden.
J Clin Nurs. 2008 Mar;17(6):726-34. doi: 10.1111/j.1365-2702.2006.01873.x. Epub 2007 Apr 5.
To describe the patients' perceptions of quality of care (QoC) in an emergency department (ED) and to analyse associations between patients' background characteristics and estimated QoC.
Each year 1.4 out of every 100 inhabitants are injured in the traffic environment and receive care at the ED. No study has yet analysed different injured road users' perceived QoC, or how important they rate different caring dimensions.
Cross-sectional study at the ED, in the University Hospital in Umeå, Sweden.
A stratified consecutive sample of 166 car occupants, 200 cyclists and 199 pedestrians, aged 18-70 years, all injured in the traffic environment. Data were collected from medical records and from a mail survey using a short form of the Quality from the Patient's Perspective questionnaire, modified for ED use. The statistical methods used included Mann-Whitney's U-test, the Kruskal-Wallis test and multiple logistic regression.
The perceived QoC and the subjective importance of the corresponding QoC dimensions were rated at the 'better' half of the rating scale, with no differences between the different road user categories. The most prominent factors associated with a positive perceived QoC rating were a short waiting time, moderate or serious injuries and high age as well as high educational level of the injury victim. For the subjective importance, a short waiting time was rated as the most important but slight differences were seen, related to education and sex.
The association patterns between the areas of perceived reality and subjective importance indicated that expectations were higher than perceived QoC, suggesting that patients expected somewhat higher QoC than they received.
Information on factors causing long waiting times, adapted to patients' age, sex and educational level, may reduce dissatisfaction among long waiting patients, especially among those with minor injuries.
描述患者对急诊科医疗质量（QoC）的认知，并分析患者背景特征与估计的医疗质量之间的关联。
每年每100名居民中有1.4人在交通环境中受伤并在急诊科接受治疗。尚无研究分析不同受伤道路使用者对医疗质量的认知，或他们对不同护理维度的重视程度。
在瑞典于默奥大学医院急诊科进行的横断面研究。
对166名汽车乘客、200名骑自行车者和199名行人进行分层连续抽样，年龄在18 - 70岁之间，均在交通环境中受伤。数据从医疗记录和使用从患者角度看质量问卷简表进行的邮件调查中收集，该问卷已针对急诊科使用进行修改。使用的统计方法包括曼 - 惠特尼U检验、克鲁斯卡尔 - 沃利斯检验和多元逻辑回归。
对医疗质量的认知以及相应医疗质量维度的主观重要性在量表的“较好”一半进行评分，不同道路使用者类别之间没有差异。与积极的医疗质量认知评分相关的最突出因素是等待时间短、中度或重度损伤、年龄较大以及受伤者的教育水平较高。对于主观重要性，等待时间短被评为最重要，但在与教育和性别相关方面存在细微差异。
感知现实领域与主观重要性之间的关联模式表明，期望高于感知的医疗质量，这表明患者期望的医疗质量略高于他们所接受的。
关于导致长时间等待的因素的信息，根据患者的年龄、性别和教育水平进行调整，可能会减少长时间等待患者的不满，特别是那些轻伤患者。
