Spooner Kiara K, Salemi Jason L, Salihu Hamisu M, Zoorob Roger J
Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
Patient Educ Couns. 2016 May;99(5):844-54. doi: 10.1016/j.pec.2015.12.007. Epub 2015 Dec 12.
This study aimed to describe disparities and temporal trends in the level of perceived patient-provider communication quality (PPPCQ) in the United States, and to identify sociodemographic and health-related factors associated with elements of PPPCQ.
A cross-sectional analysis was conducted using nationally-representative data from the 2011-2013 iterations of the Health Information National Trends Survey (HINTS). Descriptive statistics, multivariable linear and logistic regression analyses were conducted to examine associations.
PPPCQ scores, the composite measure of patients' ratings of communication quality, were positive overall (82.8; 95% CI: 82.1-83.5). However, less than half (42-46%) of respondents perceived that providers always addressed their feelings, spent enough time with them, or helped with feelings of uncertainty about their health. Older adults and those with a regular provider consistently had higher PPPCQ scores, while those with poorer perceived general health were consistently less likely to have positive perceptions of their providers' communication behaviors.
Disparities in PPPCQ can be attributed to patients' age, race/ethnicity, educational attainment, employment status, income, healthcare access and general health.
These findings may inform educational and policy efforts which aim to improve patient-provider communication, enhance the quality of care, and reduce health disparities.
本研究旨在描述美国患者对医患沟通质量（PPPCQ）感知水平的差异及时间趋势，并确定与PPPCQ各要素相关的社会人口学和健康相关因素。
使用来自2011 - 2013年健康信息国家趋势调查（HINTS）各轮次的全国代表性数据进行横断面分析。进行描述性统计、多变量线性和逻辑回归分析以检验相关性。
PPPCQ得分，即患者对沟通质量评分的综合指标，总体呈正向（82.8；95%置信区间：82.1 - 83.5）。然而，不到一半（42 - 46%）的受访者认为医护人员总是关注他们的感受、与他们相处足够的时间或帮助他们消除对自身健康的不确定感。老年人和有固定医护人员的患者PPPCQ得分一直较高，而自我感觉总体健康状况较差的患者对医护人员沟通行为持积极看法的可能性一直较低。
PPPCQ的差异可归因于患者的年龄、种族/族裔、教育程度、就业状况、收入、医疗保健可及性和总体健康状况。
这些发现可能为旨在改善医患沟通、提高医疗质量和减少健康差距的教育和政策努力提供参考。
