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人际护理过程与患者满意度:种族、民族和语言对二者关联有影响吗?

Interpersonal processes of care and patient satisfaction: do associations differ by race, ethnicity, and language?

作者信息

Nápoles Anna María, Gregorich Steven E, Santoyo-Olsson Jasmine, O'Brien Helen, Stewart Anita L

机构信息

Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, Division of General Internal Medicine, University of California, San Francisco, CA 94118-1944, USA. anna.napoles-springer@.ucsf.edu

出版信息

Health Serv Res. 2009 Aug;44(4):1326-44. doi: 10.1111/j.1475-6773.2009.00965.x. Epub 2009 Mar 31.

Abstract

OBJECTIVE

Describe association of patient satisfaction with interpersonal processes of care (IPC) by race/ethnicity.

DATA SOURCES/STUDY SETTING: Interview with 1,664 patients (African Americans, English- and Spanish-speaking Latinos, and non-Latino Whites).

STUDY DESIGN/METHODS: Cross-sectional study of seven IPC measures (communication, patient-centered decision making, and interpersonal style) and three satisfaction measures (satisfaction with physicians, satisfaction with health care, and willingness to recommend physicians). Regression models explored associations, controlling for patient characteristics.

PRINCIPAL FINDINGS

In all groups: patient-centered decision making was positively associated with satisfaction with physicians (B=0.10, p<.0001) and health care (B=0.07, p<.001), and "recommend physicians" (OR=1.23, 95 percent CI 1.06, 1.43); discrimination was negatively associated with satisfaction with physicians (B=0.09, p<.05) and health care (B=0.17, p<.001). Unclear communication was associated with less satisfaction with physicians among Spanish-speaking Latinos. Explaining results was positively associated with all satisfaction outcomes for all groups with one exception (no association with satisfaction with physicians for Latino Spanish-speakers). Compassion/respect was positively associated with all outcomes for all groups with two exceptions (no association with satisfaction with health care among English-speaking Latinos and Whites).

CONCLUSIONS

All IPC measures were associated with at least one satisfaction outcome for all groups except for unclear communication.

摘要

目的

描述按种族/民族划分的患者满意度与人际护理过程(IPC)之间的关联。

数据来源/研究背景:对1664名患者(非裔美国人、说英语和西班牙语的拉丁裔以及非拉丁裔白人)进行访谈。

研究设计/方法:对七项IPC指标(沟通、以患者为中心的决策制定和人际风格)以及三项满意度指标(对医生的满意度、对医疗保健的满意度以及推荐医生的意愿)进行横断面研究。回归模型探讨了关联,并对患者特征进行了控制。

主要发现

在所有组中:以患者为中心的决策制定与对医生的满意度(B = 0.10,p <.0001)、对医疗保健的满意度(B = 0.07,p <.001)以及“推荐医生”(OR = 1.23,95%置信区间1.06,1.43)呈正相关;歧视与对医生的满意度(B = 0.09,p <.05)和对医疗保健的满意度(B = 0.17,p <.001)呈负相关。沟通不清晰与说西班牙语的拉丁裔对医生的满意度较低有关。解释结果与所有组的所有满意度结果呈正相关,但有一个例外(说西班牙语的拉丁裔对医生的满意度无关联)。同情/尊重与所有组的所有结果呈正相关,但有两个例外(说英语的拉丁裔和白人对医疗保健的满意度无关联)。

结论

除沟通不清晰外,所有IPC指标与所有组的至少一项满意度结果相关。

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