Emrich Inken Annegret, Fröhlich-Güzelsoy Leyla, Bruns Florian, Friedrich Bernd, Frewer Andreas
, Glueckstrasse 10, 91054, Erlangen, Germany,
HEC Forum. 2014 Jun;26(2):111-24. doi: 10.1007/s10730-013-9225-1.
In recent years, the rights of patients have assumed a more pivotal role in international discussion. Stricter laws on the protection of patients place greater priority on the perspective and the status of patients. The purpose of this study is to emphasize ethical aspects in communication, the role of patient advocates as contacts for the concerns and suggestions of patients, and how many problems of ethics disappear when communication is highlighted. We reviewed 680 documented cases of consultation in a 10-year period of patient advocates' activity at a big German university hospital with 1,300 beds. On the basis of this extensive material, the article will focus on the intersection of the advocate's work with the problems of patients in hospitals. Deficits in the level of communication between health care professionals and patients were frequently uncovered. Patients primarily complain about the lack of dialogue and empathy. Middle-aged patients consulted the patients' advocate disproportionately more often. Measured against this baseline, the group of 65 and older complained less frequently. Besides complaints the advocate was asked in more than one-third of all cases for information about medical matters, hospital regulations or administrative problems. Patients obviously see the advocate as a well-connected and ideally unbiased contact person for uncertainties concerning their malady or a potential stay in hospital. Those seeking help often set hope in the information given by the voluntary patient representative. It should be highly recommended for every German hospital to establish the position of a patient advocate. Furthermore, patients can profit from regular exchange between the advocate and the Ethics Committee, also, to help ensure that their rights are taken into account and implemented in an ethically desirable context.
近年来，患者权利在国际讨论中发挥着更为关键的作用。更严格的患者保护法律更加重视患者的视角和地位。本研究的目的是强调沟通中的伦理问题、患者权益倡导者作为患者关切和建议联系人的作用，以及当沟通得到重视时，有多少伦理问题会消失。我们回顾了德国一家拥有1300张床位的大型大学医院在患者权益倡导者10年活动期间记录的680例咨询案例。基于这些丰富的资料，本文将聚焦于倡导者的工作与医院中患者问题的交叉点。医护人员与患者之间的沟通水平经常存在不足。患者主要抱怨缺乏对话和同理心。中年患者向患者权益倡导者咨询的频率格外高。与这个基线相比，65岁及以上的人群抱怨频率较低。除了投诉之外，在超过三分之一的案例中，倡导者还被问及有关医疗事项、医院规定或行政问题的信息。显然，患者将倡导者视为在其疾病或可能住院的不确定性方面人脉广泛且理想情况下公正无偏的联系人。寻求帮助的人往往寄希望于患者志愿代表提供的信息。强烈建议德国的每家医院都设立患者权益倡导者这一职位。此外，患者可以从倡导者与伦理委员会之间的定期交流中受益，这也有助于确保他们的权利在符合伦理要求的背景下得到考虑和落实。
