Harrison Reema, Walton Merrilyn, Manias Elizabeth, Smith-Merry Jennifer, Kelly Patrick, Iedema Rick, Robinson Lauren
School of Public Health, Sydney Medical School, University of Sydney, Rm 314 Edward Ford Building (A27), Sydney, NSW 2006, Australia.
School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC 3125, Australia Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC 3125, Australia.
Int J Qual Health Care. 2015 Dec;27(6):424-42. doi: 10.1093/intqhc/mzv075. Epub 2015 Sep 29.
Preventable patient harm due to adverse events (AEs) is a significant health problem today facing contemporary health care. Knowledge of patients' experiences of AEs is critical to improving health care safety and quality. A systematic review of studies of patients' experiences of AEs was conducted to report their experiences, knowledge gaps and any challenges encountered when capturing patient experience data.
Key words, synonyms and subject headings were used to search eight electronic databases from January 2000 to February 2015, in addition to hand-searching of reference lists and relevant journals.
Titles and abstracts of publications were screened by two reviewers and checked by a third. Full-text articles were screened against the eligibility criteria.
Data on design, methods and key findings were extracted and collated.
Thirty-three publications demonstrated patients identifying a range of problems in their care; most commonly identified were medication errors, communication and coordination of care problems. Patients' income, education, health burden and marital status influence likelihood of reporting. Patients report distress after an AE, often exacerbated by receiving inadequate information about the cause. Investigating patients' experiences is hampered by the lack of large representative patient samples, data over sufficient time periods and varying definitions of an AE.
Despite the emergence of policy initiatives to enhance patient engagement, few studies report patients' experiences of AEs. This information must be routinely captured and utilized to develop effective, patient-centred and system-wide policies to minimize and manage AEs.
因不良事件（AE）导致的可预防患者伤害是当代医疗保健目前面临的一个重大健康问题。了解患者对不良事件的体验对于提高医疗保健安全和质量至关重要。对有关患者不良事件体验的研究进行了系统综述，以报告他们的体验、知识差距以及在收集患者体验数据时遇到的任何挑战。
除了手工检索参考文献列表和相关期刊外，还使用关键词、同义词和主题词从2000年1月至2015年2月检索了八个电子数据库。
由两名评审员筛选出版物的标题和摘要，并由第三名评审员进行检查。根据纳入标准对全文进行筛选。
提取并整理有关设计、方法和主要发现的数据。
33篇出版物表明患者在其护理中识别出一系列问题；最常识别出的是用药错误、护理的沟通与协调问题。患者的收入、教育程度、健康负担和婚姻状况会影响报告的可能性。患者在不良事件后报告有痛苦，通常因未获得关于病因的充分信息而加剧。由于缺乏具有代表性的大样本患者、足够长时间的数据以及不良事件的不同定义，对患者体验的调查受到阻碍。
尽管出台了增强患者参与度的政策举措，但很少有研究报告患者对不良事件的体验。必须定期收集并利用这些信息，以制定有效、以患者为中心且全系统的政策，以尽量减少和管理不良事件。
