Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 259 E Erie St, Ste 475, Chicago, IL 60611, USA.
Mayo Clin Proc. 2010 Jan;85(1):47-52. doi: 10.4065/mcp.2009.0232.
To evaluate hospitalized patients' understanding of their plan of care.
Interviews of a cross-sectional sample of hospitalized patients and their physicians were conducted from June 6 through June 26, 2008. Patients were asked whether they knew the name of the physician and nurse responsible for their care and specific questions about 6 aspects of the plan of care for the day (primary diagnosis, planned tests, planned procedures, medication changes, physician services consulted, and the expected length of stay). Physicians were interviewed and asked about the plan of care in the same fashion as for the patients. Two board-certified internists reviewed responses and rated patient-physician agreement on each aspect of the plan of care as none, partial, or complete agreement.
Of 250 eligible patients, 241 (96%) agreed to be interviewed. A total of 233 (97%) of 241 physicians completed the interview, although sample sizes vary because of missing data elements. Of 239 patients, 77 (32%) correctly named at least 1 of their hospital physicians, and 143 patients (60%) correctly named their nurses. For each aspect of care, patients and physicians lacked agreement on the plan of care in a large number of instances. Specifically, there was no agreement between patients and physicians on planned tests or procedures for the day in 87 (38%) of 231 [corrected] instances and in 22 (10%) of 231 [corrected] instances. Complete agreement on the anticipated length of stay occurred in only 85 (39%) of 218 instances.
A substantial portion of hospitalized patients do not understand their plan of care. Patients' limited understanding of their plan of care may adversely affect their ability to provide informed consent for hospital treatments and to assume their own care after discharge.
评估住院患者对其治疗方案的理解程度。
于 2008 年 6 月 6 日至 6 月 26 日，对住院患者及其医生进行了横断面样本的访谈。患者被问及是否知道负责其护理的医生和护士的姓名，以及有关当天治疗方案的 6 个方面的具体问题（主要诊断、计划检查、计划手术、药物变化、咨询的医生服务以及预期住院时间）。以同样的方式对医生进行了访谈，并询问了他们关于治疗方案的问题。两名具有董事会认证资格的内科医生审查了答复，并对患者-医生在治疗方案的每个方面的一致性进行了无、部分或完全一致的评估。
在 250 名符合条件的患者中，有 241 名（96%）同意接受访谈。共有 233 名（97%）的 241 名医生完成了访谈，尽管由于缺少数据元素，样本量有所不同。在 239 名患者中，有 77 名（32%）至少正确地说出了 1 名医院医生的名字，有 143 名患者（60%）正确地说出了他们的护士的名字。在每个护理方面，患者和医生在治疗方案上都存在大量不一致的情况。具体来说，在 231 个[修正]实例中有 87 个（38%）和在 231 个[修正]实例中有 22 个（10%），患者和医生在当天的计划检查或手术方面没有达成一致；在只有 85 个（39%）的 218 个实例中，对预期的住院时间完全达成一致。
相当一部分住院患者不了解其治疗方案。患者对其治疗方案的理解有限，可能会对他们为医院治疗提供知情同意以及在出院后承担自己的护理产生不利影响。
