Hayes Eileen
School of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
J Am Acad Nurse Pract. 2007 Aug;19(8):418-26. doi: 10.1111/j.1745-7599.2007.00245.x.
To explore patient satisfaction, intention to adhere to nurse practitioner (NP) plan of care, and the impact of managed care on NPs' patients in multiple settings, the final phase of a three-part study of NPs and managed care.
Postvisit questionnaires and narrative comments about patient satisfaction with NP communication, overall satisfaction with visit, recall of plan of care, intention to adhere to NP's recommendations, and impact of managed care on ease of obtaining healthcare resources.
Patients were very satisfied with NP communication and with their healthcare visit. They mostly intended to adhere to the NP-recommended plan of care but less so to recommended lifestyle changes. Patients trusted their NPs, valued their expertise, were confident in the NPs' care, and believed that the NPs considered their best interests. They appreciated that the NPs took time to listen to their concerns and helped them to obtain healthcare resources. Most patients were not greatly impacted by managed care and obtained needed healthcare resources with little difficulty.
Although the first two phases of this study found that many NPs had strong negative attitudes toward managed care, these attitudes were not conveyed toward patients in this sample. NPs, however, will continue to face new challenges as third-party payers attempt to reduce healthcare costs, further testing NP adaptability and resourcefulness.
作为对执业护士与管理式医疗的三部分研究的最后阶段，探讨患者满意度、遵循执业护士护理计划的意愿，以及管理式医疗在多种环境中对执业护士患者的影响。
访后问卷以及关于患者对执业护士沟通的满意度、对就诊的总体满意度、对护理计划的回忆、遵循执业护士建议的意愿，以及管理式医疗对获取医疗资源便利性的影响的叙述性评论。
患者对执业护士的沟通及医疗就诊非常满意。他们大多打算遵循执业护士推荐的护理计划，但对推荐的生活方式改变的遵循度较低。患者信任他们的执业护士，重视其专业知识，对执业护士的护理有信心，并认为执业护士考虑到了他们的最大利益。他们赞赏执业护士花时间倾听他们的担忧并帮助他们获取医疗资源。大多数患者未受到管理式医疗的重大影响，且能轻松获得所需的医疗资源。
尽管本研究的前两个阶段发现许多执业护士对管理式医疗持强烈的负面态度，但在这个样本中这些态度并未传达给患者。然而，随着第三方支付方试图降低医疗成本，执业护士将继续面临新的挑战，这将进一步考验执业护士的适应能力和应变能力。
