Tremblay Dominique, Roberge Danièle, Berbiche Djamal
Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada.
Charles-Le Moyne Hospital Research Centre, Greenfield Park, Longueuil, QC, Canada.
BMC Health Serv Res. 2015 Sep 28;15:425. doi: 10.1186/s12913-015-1104-9.
In coming years, patient-reported data are expected to play a more prominent role in ensuring early and efficient detection of healthcare system dysfunctions, developing interventions and evaluating their effects on health outcomes, and monitoring quality of care from the patient's perspective. The concept of responsiveness relates to patient-reported experience measures that focus on the system's response to service users' legitimate expectations. We explored this concept in an effort to address unresolved issues related to measuring and interpreting patient experience. Our objectives in this study were to report on patients' perceptions of cancer services responsiveness and to identify patient characteristics and organizational attributes that are potential determinants of a positive patient-reported experience.
A cross-sectional survey was conducted of 1379 cancer patients in nine participating ambulatory cancer clinics in hospitals across the province of Quebec, Canada. They were invited to complete the Cancer Services Responsiveness tool, a 19-item questionnaire evaluating patients' perceptions of the responsiveness of cancer services. Sociodemographic data and self-reported clinical and organizational data were collected. Descriptive statistical analysis, univariate and multivariate logistic regressions were performed.
The patients surveyed generally perceived cancer services as highly responsive. The individual determinants of overall responsiveness found to be significant were self-assessed health status, age, and education level; organizational determinants were academic affiliation and geographic location of the clinic.
Responsiveness refers to distinctive indicators of healthcare quality focused on patient-provider interactions and presents a complementary picture to other patient-reported experience measures. The identified determinants of patients' positive experience with cancer services provide valuable information to guide care providers in targeting quality improvements.
Finally, our results suggest these determinants should be further studied to eliminate confounders and produce usable results.
在未来几年,患者报告的数据有望在确保早期且高效地发现医疗系统功能障碍、制定干预措施并评估其对健康结果的影响以及从患者角度监测医疗质量方面发挥更突出的作用。响应性概念与患者报告的体验指标相关,这些指标侧重于系统对服务使用者合理期望的响应。我们探讨了这一概念,以解决与测量和解释患者体验相关的未解决问题。本研究的目的是报告患者对癌症服务响应性的看法,并确定可能是积极的患者报告体验的潜在决定因素的患者特征和组织属性。
对加拿大魁北克省各医院9家参与的门诊癌症诊所的1379名癌症患者进行了横断面调查。邀请他们完成癌症服务响应性工具,这是一份包含19个条目的问卷,用于评估患者对癌症服务响应性的看法。收集了社会人口统计学数据以及自我报告的临床和组织数据。进行了描述性统计分析、单变量和多变量逻辑回归分析。
接受调查的患者普遍认为癌症服务具有高度响应性。发现对总体响应性有显著影响的个体决定因素是自我评估的健康状况、年龄和教育水平;组织决定因素是诊所的学术隶属关系和地理位置。
响应性指的是侧重于患者与提供者互动的医疗质量独特指标,并且为其他患者报告的体验指标提供了补充情况。所确定的患者对癌症服务的积极体验的决定因素为指导护理提供者确定质量改进目标提供了有价值的信息。
最后,我们的结果表明应进一步研究这些决定因素,以消除混杂因素并得出可用的结果。