Keulers B J, Scheltinga M R M, Houterman S, Van Der Wilt G J, Spauwen P H M
Máxima Medical Centre (MMC), Veldhoven, The Netherlands.
World J Surg. 2008 Jun;32(6):964-70. doi: 10.1007/s00268-008-9581-1.
Provision of adequate patient information may contribute to a "satisfying" surgical treatment. The patient's views on successful transfer of information concerning operative characteristics may not be in concert with the surgeon's. The aim of the present study was to determine opinions of both surgeons and patients about issues of surgical information.
A group of surgeons (n = 24) and surgical patients (n = 125) responded to a questionnaire that included 80 topics involving domains of information on disease, physical examination, preoperative period, anesthesia, operation, postoperative period, self care, and general hospital issues. Both groups were asked for their opinion on what they considered important and useful preoperative information for patients. Questions were scored with a visual analog scale. The reliability of the questionnaire was calculated with Cronbach's alpha. Differences in opinions between surgeons and patients were analyzed with Student's t-test.
The Cronbach's alpha of the questionnaire was high (0.91), indicating its high reliability. Patients scored significantly higher (p < 0.001) in most domains, including preoperative period, anaesthesia, operation, postoperative period, self care, and general hospital information. Women demonstrated a significantly higher need for information than men did. These findings were independent of patient age or complexity of operation. In contrast, surgeons thought that their patients desired more extensive information on cause, effect, and prognosis of the disease itself (p < 0.001).
Surgeons generally underestimate their patients' desire for receiving extensive information prior to a surgical procedure of any complexity. Surgeons should develop strategies to bridge this informational mismatch.
提供充分的患者信息可能有助于实现“令人满意的”手术治疗。患者对于手术特征相关信息成功传递的看法可能与外科医生不一致。本研究的目的是确定外科医生和患者对于手术信息问题的看法。
一组外科医生(n = 24)和外科患者(n = 125)对一份问卷进行了回复,该问卷包含80个主题,涉及疾病、体格检查、术前阶段、麻醉、手术、术后阶段、自我护理和综合医院问题等信息领域。两组都被问及他们认为对患者重要且有用的术前信息是什么。问题采用视觉模拟量表进行评分。问卷的信度用克朗巴哈系数计算。外科医生和患者之间的意见差异用学生t检验分析。
问卷的克朗巴哈系数较高(0.91),表明其信度较高。在大多数领域,患者的得分显著更高(p < 0.001),包括术前阶段、麻醉、手术、术后阶段、自我护理和综合医院信息。女性对信息的需求明显高于男性。这些发现与患者年龄或手术复杂性无关。相比之下,外科医生认为他们的患者希望获得关于疾病本身的病因、影响和预后的更广泛信息(p < 0.001)。
外科医生通常低估了患者在任何复杂程度的手术前接收广泛信息的愿望。外科医生应制定策略来弥合这种信息不匹配的情况。