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卫生保健专业人员对参与安全相关行为的态度的预测因素。

Predictors of health care professionals' attitudes towards involvement in safety-relevant behaviours.

机构信息

Clinical Safety Research Unit, Department of Bio-Surgery and Surgical Technology, Imperial College London, London, UK.

出版信息

J Eval Clin Pract. 2014 Feb;20(1):12-9. doi: 10.1111/jep.12073. Epub 2013 Aug 13.

Abstract

BACKGROUND

Patients can make valuable contributions towards promoting the safety of their health care. Health care professionals (HCPs) could play an important role in encouraging patient involvement in safety-relevant behaviours. However, to date factors that determine HCPs' attitudes towards patient participation in this area remain largely unexplored.

OBJECTIVE

To investigate predictors of HCPs' attitudes towards patient involvement in safety-relevant behaviours.

DESIGN

A 22-item cross-sectional fractional factorial survey that assessed HCPs' attitudes towards patient involvement in relation to two error scenarios relating to hand hygiene and medication safety.

SETTING

Four hospitals in London

PARTICIPANTS

Two hundred sixteen HCPs (116 doctors; 100 nurses) aged between 21 and 60 years (mean: 32): 129 female.

OUTCOME MEASURES

Approval of patient's behaviour, HCP response to the patient, anticipated effects on the patient-HCP relationship, support for being asked as a HCP, affective rating response to the vignettes.

RESULTS

HCPs elicited more favourable attitudes towards patients intervening about a medication error than about hand sanitation. Across vignettes and error scenarios, the strongest predictors of attitudes were how the patient intervened and how the HCP responded to the patient's behaviour. With regard to HCP characteristics, doctors viewed patients intervening less favourably than nurses.

CONCLUSIONS

HCPs perceive patients intervening about a potential error less favourably if the patient's behaviour is confrontational in nature or if the HCP responds to the patient intervening in a discouraging manner. In particular, if a HCP responds negatively to the patient (irrespective of whether an error actually occurred), this is perceived as having negative effects on the HCP-patient relationship.

摘要

背景

患者可以为促进其医疗保健安全做出有价值的贡献。医疗保健专业人员(HCP)在鼓励患者参与与安全相关的行为方面可以发挥重要作用。然而,迄今为止,决定 HCP 对患者参与这一领域的态度的因素在很大程度上仍未得到探索。

目的

调查 HCP 对患者参与与安全相关行为的态度的预测因素。

设计

一项 22 项横断面分面因子调查,评估了 HCP 对患者参与与手部卫生和药物安全相关的两个错误情景的态度。

设置

伦敦的四家医院

参与者

216 名 HCP(116 名医生;100 名护士)年龄在 21 至 60 岁之间(平均:32 岁):129 名女性。

结果测量

对患者行为的认可、HCP 对患者的反应、对患者-HCP 关系的预期影响、作为 HCP 被询问的支持、对情景的情感反应。

结果

与手部卫生相比,HCP 对患者干预药物错误的行为表现出更有利的态度。在不同的情景和错误场景中,态度的最强预测因素是患者的干预方式和 HCP 对患者行为的反应方式。就 HCP 特征而言,医生比护士对患者干预的看法更为不利。

结论

如果患者的行为具有对抗性,或者 HCP 以令人沮丧的方式回应患者的干预,HCP 会对患者干预潜在错误的看法不太有利。特别是,如果 HCP对患者做出负面反应(无论是否真的发生了错误),则会被视为对 HCP-患者关系产生负面影响。

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