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中国肺癌和肝癌患者的患者满意度与生活质量之间的关联。

The association between patient satisfaction and quality of life in Chinese lung and liver cancer patients.

作者信息

Wong Wing S, Fielding Richard

机构信息

Health Behavioral Research Group, Department of Community Medicine and Unit for Behavioral Sciences, School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong.

出版信息

Med Care. 2008 Mar;46(3):293-302. doi: 10.1097/MLR.0b013e31815b9785.

Abstract

BACKGROUND

Patient satisfaction has been accorded increased importance in evaluating the quality of health care. However, only a few studies have examined factors associated with patient satisfaction in cancer populations, with no data currently available in Chinese oncology populations.

OBJECTIVES

We sought to examine the longitudinal course of the relationship between patient satisfaction and quality of life (QoL) in Chinese cancer patients.

METHODS

A total of 253 liver cancer patients and 334 lung cancer patients were assessed during their first outpatient visit (baseline) and at 2 follow-up interviews (FU1 and FU2). QoL was measured by the Chinese version of the Functional Assessment of Cancer Therapy-General Scale [FACT-G (Ch)]. Patient satisfaction was assessed by the Nine-Item Chinese Patient Satisfaction Questionnaire (ChPSQ-9) and the cognitive subscale of the Medical Interview Satisfaction Scale (MISS-Cog). Linear mixed effects (LME) models were fitted to identify predictors of patient satisfaction and QoL.

RESULTS

Results of LME analyses showed no significant between-group differences in psychosocial, satisfaction, and QoL measures over time (all P > 0.05). Age [beta = -0.001, 95% confidence interval (CI): -0.03 to 0.00, P < 0.05] and optimism (beta = 0.20, 95% CI: 0.10 to 0.30, P < 0.001) predicted MISS-Cog and ChPSQ-9, respectively. After adjusting for sociodemographic and psychosocial variables, only ChPSQ-9 (beta = 0.12, 95% CI: 0.06 to 0.18, P < 0.001) predicted QoL scores. No significant association between MISS-Cog and QoL was found.

CONCLUSIONS

General emotional support from health professionals (ChPSQ-9) was a more effective predictor of QoL than was a measure of informational support (MISS-Cog) among these patients. Because expectations of clinical care likely vary by culture, and nature and stage of disease, measures of patient satisfaction that address both informational and care expectations are important.

摘要

背景

在评估医疗保健质量时,患者满意度已受到越来越多的重视。然而,仅有少数研究探讨了癌症患者群体中与患者满意度相关的因素,目前尚无针对中国肿瘤患者群体的数据。

目的

我们试图研究中国癌症患者中患者满意度与生活质量(QoL)之间关系的纵向变化过程。

方法

共有253例肝癌患者和334例肺癌患者在首次门诊就诊时(基线)以及两次随访访谈时(FU1和FU2)接受评估。生活质量通过中文版癌症治疗功能评价通用量表[FACT-G(Ch)]进行测量。患者满意度通过九项中文版患者满意度问卷(ChPSQ-9)和医疗访谈满意度量表的认知子量表(MISS-Cog)进行评估。采用线性混合效应(LME)模型来确定患者满意度和生活质量的预测因素。

结果

LME分析结果显示,随着时间推移,心理社会、满意度和生活质量测量指标在组间无显著差异(所有P>0.05)。年龄[β=-0.001,95%置信区间(CI):-0.03至0.00,P<0.05]和乐观情绪(β=0.20,95%CI:0.10至0.30,P<0.001)分别预测了MISS-Cog和ChPSQ-9。在调整社会人口统计学和心理社会变量后,只有ChPSQ-9(β=0.12,95%CI:0.06至0.18,P<0.001)能够预测生活质量得分。未发现MISS-Cog与生活质量之间存在显著关联。

结论

在这些患者中,来自医护人员的一般情感支持(ChPSQ-9)比信息支持测量指标(MISS-Cog)更能有效预测生活质量。由于临床护理的期望可能因文化、疾病性质和阶段而异,兼顾信息和护理期望的患者满意度测量指标很重要。

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