Ruiz-Moral Roger, Pérula de Torres Luis Ángel, Muñoz Alamo Miguel, Jiménez García Celia, González Nebauer Valeria, Alba Dios Antonia, Barrios Blasco Luciano, Criado Larumbe Margarita
Unidad Docente Provincial de Medicina de Familia y Comunitaria de Córdoba, Servicio Andaluz de Salud, España.
Rev Esp Salud Publica. 2011 Jun;85(3):315-22. doi: 10.1590/S1135-57272011000300010.
Different aspects of the doctor-patient relationship were associated with satisfaction and other outcomes of the consultation. However, measurements of the perception of communication quality are often limited by the "ceiling effect". To evaluate the relationship and differences between three ways to obtain information regarding patient satisfaction and perception of unmet needs in communication aspects with your doctor.
An observational descriptive study was design. Patient perception regarding four communicational domains when attending family doctors measured by means of three different type of questions.
658 (91%) patients attending the consultation of 97 physicians in 58 Health Centres. 401 (62%) of them were females. Average age 52 years (TD:17,4; CI95%: 50,6-53,3 years), 401 females (62%: CI95%: 58,7-66,4%). In close ended questions, patients declared high rates of satisfaction for all the communicative domains studied: relationship 99,7% (CI95%: 98,8-99,9%), explaining reasons for consultation (CI95%: 94,4-97,7%), information regarding causes 96,2% (CI95%: 89,9- 94,3%), and therapeutic plan 97,9% (CI95%:96,7-99,1%). Patients declared as insatisfied gave high number of suggestions or showed more discrepancy of frequency (p<0.05); nevertheless, up to 28,9% of satisfied patients made suggestions for improving communication (p<0,001).
[corrected] Designing open-ended questions where patient can make suggestions, seems to be a good method for detecting unmet needs in doctor patient communication that close-ended question about satisfaction or those exploring possible discrepancy on the frequency of some behaviours.
医患关系的不同方面与咨询的满意度及其他结果相关。然而,沟通质量感知的测量常常受到“天花板效应”的限制。为了评估三种获取患者满意度信息以及在与医生沟通方面未满足需求感知的方法之间的关系和差异。
设计了一项观察性描述性研究。通过三种不同类型的问题测量患者在就诊于家庭医生时对四个沟通领域的感知。
58个健康中心的97名医生的咨询中有658名(91%)患者参与。其中401名(62%)为女性。平均年龄52岁(标准差:17.4;95%置信区间:50.6 - 53.3岁),401名女性(62%:95%置信区间:58.7 - 66.4%)。在封闭式问题中,患者对所研究的所有沟通领域都宣称了较高的满意度:关系99.7%(95%置信区间:98.8 - 99.9%),解释咨询原因(95%置信区间:94.4 - 97.7%),关于病因的信息96.2%(95%置信区间:89.9 - 94.3%),以及治疗方案97.9%(95%置信区间:96.7 - 99.1%)。宣称不满意的患者提出了大量建议或表现出频率上的更多差异(p<0.05);然而,高达28.9%的满意患者也提出了改善沟通的建议(p<0.001)。
设计开放式问题让患者能够提出建议,似乎是一种检测医患沟通中未满足需求的好方法,优于关于满意度的封闭式问题或那些探究某些行为频率可能差异的问题。