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未能满足精神需求是否与癌症患者对医疗质量的认知及其对护理的满意度相关?

Is failure to meet spiritual needs associated with cancer patients' perceptions of quality of care and their satisfaction with care?

作者信息

Astrow Alan B, Wexler Ann, Texeira Kenneth, He M Kai, Sulmasy Daniel P

机构信息

Maimonides Medical Center, Brooklyn, NY, USA.

出版信息

J Clin Oncol. 2007 Dec 20;25(36):5753-7. doi: 10.1200/JCO.2007.12.4362.

Abstract

PURPOSE

Few studies regarding patients' views about spirituality and health care have included patients with cancer who reside in the urban, northeastern United States. Even fewer have investigated the relationship between patients' spiritual needs and perceptions of quality and satisfaction with care.

PATIENTS AND METHODS

Outpatients (N = 369) completed a questionnaire at the Saint Vincent's Comprehensive Cancer Center in New York, NY. The instrument included the Quality of End-of-Life Care and Satisfaction with Treatment quality-of-care scale and questions about spiritual and religious beliefs and needs.

RESULTS

The participants' mean age was 58 years; 65% were female; 67% were white; 65% were college educated; and 32% had breast cancer. Forty-seven percent were Catholic; 19% were Jewish; 16% were Protestant; and 6% were atheist or agnostic. Sixty-six percent reported that they were spiritual but not religious. Only 29% attended religious services at least once per week. Seventy-three percent reported at least one spiritual need; 58% thought it appropriate for physicians to inquire about their spiritual needs. Eighteen percent reported that their spiritual needs were not being met. Only 6% reported that any staff members had inquired about their spiritual needs (0.9% of inquiries by physicians). Patients who reported that their spiritual needs were not being met gave lower ratings of the quality of care (P = .009) and reported lower satisfaction with care (P = .006).

CONCLUSION

Most patients had spiritual needs. A slight majority thought it appropriate to be asked about these needs, although fewer thought this compared with reports in other settings. Few had their spiritual needs addressed by the staff. Patients whose spiritual needs were not met reported lower ratings of quality and satisfaction with care.

摘要

目的

关于患者对灵性与医疗保健看法的研究中,很少有纳入居住在美国东北部城市的癌症患者。更少的研究调查了患者的灵性需求与对医疗质量和满意度认知之间的关系。

患者与方法

门诊患者(N = 369)在纽约市圣文森特综合癌症中心完成了一份问卷。该问卷包括临终关怀质量和对治疗质量的满意度量表,以及关于灵性和宗教信仰与需求的问题。

结果

参与者的平均年龄为58岁;65%为女性;67%为白人;65%接受过大学教育;32%患有乳腺癌。47%是天主教徒;19%是犹太教徒;16%是新教徒;6%是无神论者或不可知论者。66%的人表示他们有灵性但并非宗教信徒。只有29%的人每周至少参加一次宗教仪式。73%的人报告至少有一种灵性需求;58%的人认为医生询问他们的灵性需求是合适的。18%的人报告他们的灵性需求未得到满足。只有6%的人报告有任何工作人员询问过他们的灵性需求(医生询问的占0.9%)。报告灵性需求未得到满足的患者对医疗质量的评分较低(P = .009),且对医疗的满意度也较低(P = .006)。

结论

大多数患者有灵性需求。略多数人认为询问这些需求是合适的,尽管与其他研究相比认为合适的人较少。很少有患者的灵性需求得到工作人员的关注。灵性需求未得到满足的患者对医疗质量和满意度的评分较低。

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