Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, HB Nijmegen, The Netherlands.
Hum Reprod. 2011 May;26(5):1119-27. doi: 10.1093/humrep/der054. Epub 2011 Mar 9.
Patient-centredness is one of the core dimensions of quality of care. It can be monitored with surveys measuring patients' experiences with care. The objective of the present study was to determine to what extent gynaecologists, physicians specializing in infertility and nurses can estimate the level of patient-centredness of their clinic.
A random sample of 1189 couples with fertility problems and 194 physicians and nurses from 29 Dutch fertility clinics participated in this cross-sectional study. Differences between patients' experiences with fertility care and professionals' perceptions of these experiences as measured with the patient-centredness questionnaire-infertility (PCQ-infertility) were calculated. The questionnaire's structure, comprising one total scale (level 1), seven subscales (level 2) and 46 single items (level 3), was used as a framework.
Response rates were 75% (n = 888) in the patient sample and 83% (n = 160) in the professional sample. Independent sample t-tests, corrected for multiple comparisons with the Bonferroni correction method (P < 0.05), showed no significant differences in mean scores on the total scale of patient-centredness for either professionals or patients. At level 2, professionals underestimated most subscales, namely, 'Accessibility', 'Communication', 'Patient involvement' and 'Competence', whereas 'Continuity of care' was overestimated. Professionals significantly and clinically relevantly misjudged 29 care aspects.
Professionals within fertility care cannot adequately evaluate their performance regarding patient-centredness, and specifically the care aspects to which their own patients attribute the greatest improvement potential. Providing detailed feedback might start improvement of patient-centredness and quality of care.
以患者为中心是医疗服务质量的核心维度之一。可以通过调查患者对医疗服务的体验来监测以患者为中心的程度。本研究的目的是确定妇科医生、不孕不育专科医生和护士在多大程度上可以估计其诊所的以患者为中心程度。
本横断面研究随机抽取了 1189 对有生育问题的夫妇和 29 家荷兰生育诊所的 194 名医生和护士参与。计算了患者对生育护理的体验与专业人员使用以患者为中心的不孕症问卷（PCQ-不孕症）测量的这些体验之间的差异。问卷的结构，包括一个总尺度（一级）、七个子量表（二级）和 46 个单项（三级），作为一个框架。
患者样本的回复率为 75%（n=888），专业人员样本的回复率为 83%（n=160）。独立样本 t 检验，经 Bonferroni 校正法（P<0.05）校正多重比较，专业人员和患者的以患者为中心总尺度的平均得分无显著差异。在二级水平上，专业人员低估了大多数子量表，即“可及性”、“沟通”、“患者参与”和“能力”，而“连续护理”则被高估。专业人员对 29 个护理方面的评估明显且具有临床意义的错误。
生育护理专业人员无法充分评估其以患者为中心的表现，特别是患者认为最有改进潜力的护理方面。提供详细的反馈可能会开始改善以患者为中心的程度和护理质量。
