Thompson E A, Dahr J, Susan M, Barron S
Bristol Homeopathic Hospital, Cotham Hill, Bristol, UK.
Homeopathy. 2007 Oct;96(4):243-6. doi: 10.1016/j.homp.2007.08.012.
To set a standard of routine goal setting with patients within their package of care at the Bristol Homeopathic Hospital. We hope goal setting will improve communication with our patients and health professional colleagues, focus outcome and improve targeting of problems. We therefore explored motivation for and expectation of hospital attendance from a patient perspective.
Questionnaire based pre-audit survey. The questionnaire was administered to 110 consecutive patients attending outpatients and 20 parents of children attending with asthma and eczema to gain understanding of motivation and expectation and more specific information for two of the commonest conditions.
Seventy percent of patients had used some form of complementary and alternative medicine (CAM), 35% had used homeopathy and only 10% had specialist homeopathic care, the majority of use being over the counter. The majority of patients had been encouraged by their General Practitioners, themselves and by word of mouth with family and friends. Few patients cited the media as a major influence. "Pull" factors such as "treating the whole person" were given greater emphasis except for parents of children with asthma and eczema for whom "push" factors such as fear of steroid side effects predominated. In the main patient expectations were reasonable with the majority hoping to see improvements in their conditions. A fifth of patients hoped to reduce conventional medications.
Patients had used CAM in general but not homeopathy in particular. Encouragement from doctors, self motivation and word of mouth most motivated patients to come and might suggest more direct communication with General Practitioners would be worthwhile. Being treated as a whole person was the most significant motivating factor, with a significant number of patients wishing to reduce medication. Goal setting and direct communication with other healthcare professionals is essential for safety, to focus outcome, and to value the role of homeopathy in a patient's healthcare. As a result we have set a standard whereby treatment goals are agreed with patients and communicated to referring health care professionals at each outpatient visit. This could be audited.
在布里斯托尔顺势疗法医院为患者制定在其护理套餐范围内进行常规目标设定的标准。我们希望目标设定能够改善与患者以及医疗专业同事的沟通，聚焦治疗结果并更好地针对问题。因此，我们从患者的角度探讨了就医的动机和期望。
基于问卷调查的预审核调查。该问卷被发放给110名连续就诊的门诊患者以及20名患有哮喘和湿疹的儿童的家长，以了解他们的动机和期望，并获取有关这两种最常见病症的更具体信息。
70%的患者使用过某种形式的补充和替代医学（CAM），35%使用过顺势疗法，只有10%接受过专业顺势疗法护理，大多数使用的是非处方药物。大多数患者受到全科医生、他们自己以及家人和朋友口碑的鼓励。很少有患者将媒体视为主要影响因素。除了患有哮喘和湿疹的儿童的家长，他们更强调“推动”因素，如对类固醇副作用的恐惧外，“治疗整个人”等“拉动”因素受到更多重视。总体而言，患者的期望是合理的，大多数人希望病情有所改善。五分之一的患者希望减少常规药物的使用。
患者总体上使用过补充和替代医学，但并非特别使用顺势疗法。医生的鼓励、自我激励和口碑是促使患者前来就医的最大动力，这可能表明与全科医生进行更直接的沟通是值得的。被视为一个完整的个体是最重要的激励因素，相当多的患者希望减少用药。目标设定以及与其他医疗保健专业人员的直接沟通对于安全、聚焦治疗结果以及重视顺势疗法在患者医疗保健中的作用至关重要。因此，我们制定了一项标准，即在每次门诊就诊时与患者商定治疗目标，并传达给转诊的医疗保健专业人员。这可以进行审核。
