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急诊科团队与患者的沟通:患者视角

Emergency department team communication with the patient: the patient's perspective.

作者信息

McCarthy Danielle M, Ellison Emily P, Venkatesh Arjun K, Engel Kirsten G, Cameron Kenzie A, Makoul Gregory, Adams James G

机构信息

Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.

出版信息

J Emerg Med. 2013 Aug;45(2):262-70. doi: 10.1016/j.jemermed.2012.07.052. Epub 2012 Sep 16.

DOI:10.1016/j.jemermed.2012.07.052
PMID:22989697
Abstract

BACKGROUND

Effective communication is important for the delivery of quality care. The Emergency Department (ED) environment poses significant challenges to effective communication.

OBJECTIVES

The objective of this study was to determine patients' perceptions of their ED team's communication skills.

METHODS

This was a cross-sectional study in an urban, academic ED. Patients completed the Communication Assessment Tool for Teams (CAT-T) survey upon ED exit. The CAT-T was adapted from the psychometrically validated Communication Assessment Tool (CAT) to measure patient perceptions of communication with a medical team. The 14 core CAT-T items are associated with a 5-point scale (5 = excellent); results are reported as the percent of participants who responded "excellent." Responses were analyzed for differences based on age, sex, race, and operational metrics (wait time, ED daily census).

RESULTS

There were 346 patients identified; the final sample for analysis was 226 patients (53.5% female, 48.2% Caucasian), representing a response rate of 65.3%. The scores on CAT-T items (reported as % "excellent") ranged from 50.0% to 76.1%. The highest-scoring items were "let me talk without interruptions" (76.1%), "talked in terms I could understand" (75.2%), and "treated me with respect" (74.3%). The lowest-scoring item was "encouraged me to ask questions" (50.0%). No differences were noted based on patient sex, race, age, wait time, or daily census of the ED.

CONCLUSIONS

The patients in this study perceived that the ED teams were respectful and allowed them to talk without interruptions; however, lower ratings were given for items related to actively engaging the patient in decision-making and asking questions.

摘要

背景

有效的沟通对于提供高质量医疗服务至关重要。急诊科环境对有效沟通构成重大挑战。

目的

本研究的目的是确定患者对其急诊科团队沟通技巧的看法。

方法

这是一项在城市学术急诊科进行的横断面研究。患者在离开急诊科时完成团队沟通评估工具(CAT-T)调查。CAT-T改编自经过心理测量验证的沟通评估工具(CAT),用于衡量患者对与医疗团队沟通的看法。CAT-T的14个核心项目采用5分制(5 = 优秀);结果报告为回答“优秀”的参与者百分比。根据年龄、性别、种族和运营指标(等待时间、急诊科每日普查)分析回答的差异。

结果

共识别出346名患者;最终用于分析的样本为226名患者(53.5%为女性,48.2%为白种人),回复率为65.3%。CAT-T项目的得分(报告为“优秀”的百分比)范围为50.0%至76.1%。得分最高的项目是“让我不受打断地说话”(76.1%)、“用我能理解的方式交谈”(75.2%)和“尊重地对待我”(74.3%)。得分最低的项目是“鼓励我提问”(50.0%)。根据患者的性别、种族、年龄、等待时间或急诊科的每日普查未发现差异。

结论

本研究中的患者认为急诊科团队很尊重人,允许他们不受打断地说话;然而,与积极让患者参与决策和提问相关的项目得分较低。

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