Department of Learning, Informatics, Management and Ethics, Stockholm Centre for Healthcare Ethics, Karolinska Institutet, Stockholm, Sweden.
Eur J Public Health. 2013 Apr;23(2):230-5. doi: 10.1093/eurpub/cks030. Epub 2012 May 2.
The way in which patients experience encounters with healthcare professionals seems to affect care outcome, but very little is known about reactions evoked by experiences of negative encounters.
To examine how patients perceive healthcare encounters, with a special focus on negative encounters and feeling wronged.
A questionnaire was sent to 10,042 long-term sickness absentees (response rate 58%). Attributable risk (AR) with 95% confidence intervals (CIs) was calculated regarding relations between experiences of different types of negative encounters with healthcare staff and of feeling wronged. To test the consistency of our results, we also analysed the AR for positive experiences and feeling respected.
Of 5802 participants, 1628 reported having experienced negative encounters, and 1036 of them also reported having felt wronged. The types of negative encounters with the highest AR for feeling wronged were 'nonchalant behaviour': AR 71.1 (95% CI 66.3-75.8) and 'treated me with disrespect': AR 54.8 (95% CI 49.8-59.8). Males in general tended to have higher ARs for feeling wronged than females, as had respondents with psychiatric diagnoses in comparison to other patients.
The present study indicates high ARs of feeling wronged among long-term sickness absentees if exposed to negative encounters in healthcare. Nonchalance and disrespect were the most important factors in this regard, but the different types of negative encounters were very much intertwined. Feeling wronged seems to be an outcome based on several experiences of negative encounters, either in a series of events or bundled together in a single event.
患者与医疗保健专业人员的互动方式似乎会影响护理效果,但对于负面互动所引发的反应知之甚少。
探讨患者如何感知医疗保健接触,特别关注负面接触和委屈感。
向 10042 名长期病假缺勤者(回应率为 58%)发送问卷。计算归因风险(AR)及其 95%置信区间(CI),以评估患者与医疗保健人员不同类型的负面接触经历和感到委屈之间的关系。为了检验结果的一致性,我们还分析了积极接触和受到尊重的 AR。
在 5802 名参与者中,有 1628 名报告经历过负面接触,其中 1036 名报告感到委屈。感到委屈的最高 AR 类型是“漠不关心的行为”:AR 为 71.1%(95%CI 66.3-75.8)和“不尊重我”:AR 为 54.8%(95%CI 49.8-59.8)。一般来说,男性比女性更容易感到委屈,与其他患者相比,有精神科诊断的患者更容易感到委屈。
本研究表明,长期病假缺勤者如果在医疗保健中遭遇负面接触,会感到委屈,且有较高的 AR。漠不关心和不尊重是这方面最重要的因素,但不同类型的负面接触非常交织在一起。感到委屈似乎是一系列负面接触经历的结果,无论是一系列事件还是捆绑在一起的单一事件。