Huber Jean Pierre, Saldutto Biagio, Hürny Christoph, Conzelmann Martin, Beutler Monique, Fusek Milos, Münzer Thomas
Zentrum für Geriatrie und Rehabilitation, Bürgerspital, Rorschacherstrasse 94, 9000 St. Gallen, Schweiz.
Z Gerontol Geriatr. 2008 Apr;41(2):124-31. doi: 10.1007/s00391-007-0454-2. Epub 2008 Mar 11.
The assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We examined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patient's spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%. The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses.
An instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.
在我们的医疗体系中，使用邮寄问卷来评估患者满意度是急性护理医院质量管理的既定方法。然而，此类调查未考虑老年患者的需求以及老年医学的跨专业方法。迄今为止，用于评估老年住院护理患者意见的经过验证的德语工具很少。我们报告了一项针对此类需求专门开发的问卷的多中心可行性研究结果。我们在瑞士的3家老年医院对1918名患者进行了检查，这些患者的中位年龄为82岁，平均简易精神状态评分（MMS）为25分。我们检查了所有已完成的书面问卷的心理测量特性。同时，我们使用相同工具评估了患者配偶或家庭成员的满意度。当该工具作为问卷使用时，回复率为32%，作为访谈使用时，回复率为60%。在问卷中，回复率取决于认知情况，MMS评分较低的患者回复率较低。邮寄给家庭成员的问卷回复率为35%。理论构建的患者满意度是可靠且有效的。不同项目领域的Cronbach - Alpha值介于0.67（酒店服务、房间质量）和0.92（医生）之间。由于回答频率较低，我们无法评估医疗治疗和疼痛治疗的质量。总体而言，患者对参与研究医院的所有医疗服务感到满意。相比之下，家庭成员对家庭成员与医生或护士之间信息流的质量满意度较低。
一种评估患者意见的工具可以很容易地引入老年医院。这样的工具可以为改善老年护理不同领域（如医疗、护理或宾客服务）的质量提供重要信息。
