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医生在初级和二级医疗保健中参与患者体验调查:一项定性研究。

Doctors' engagements with patient experience surveys in primary and secondary care: a qualitative study.

作者信息

Farrington Conor, Burt Jenni, Boiko Olga, Campbell John, Roland Martin

机构信息

Cambridge Centre for Health Services Research (CCHSR), Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, UK.

Department of Primary Care and Public Health, King's College London, London, UK.

出版信息

Health Expect. 2017 Jun;20(3):385-394. doi: 10.1111/hex.12465. Epub 2016 Apr 28.

Abstract

BACKGROUND

Patient experience surveys are increasingly important in the measurement of, and attempts to improve, health-care quality. To date, little research has focused upon doctors' attitudes to surveys which give them personalized feedback.

AIM

This paper explores doctors' perceptions of patient experience surveys in primary and secondary care settings in order to deepen understandings of how doctors view the plausibility of such surveys.

DESIGN, SETTING AND PARTICIPANTS: We conducted a qualitative study with doctors in two regions of England, involving in-depth semi-structured interviews with doctors working in primary care (n = 21) and secondary care (n = 20) settings. The doctors in both settings had recently received individualized feedback from patient experience surveys.

FINDINGS

Doctors in both settings express strong personal commitments to incorporating patient feedback in quality improvement efforts. However, they also concurrently express strong negative views about the credibility of survey findings and patients' motivations and competence in providing feedback. Thus, individual doctors demonstrate contradictory views regarding the plausibility of patient surveys, leading to complex, varied and on balance negative engagements with patient feedback.

DISCUSSION

Doctors' contradictory views towards patient experience surveys are likely to limit the impact of such surveys in quality improvement initiatives in primary and secondary care. We highlight the need for 'sensegiving' initiatives (i.e. attempts to influence perceptions by communicating particular ideas, narratives and visions) to engage with doctors regarding the plausibility of patient experience surveys.

CONCLUSION

This study highlights the importance of engaging with doctors' views about patient experience surveys when developing quality improvement initiatives.

摘要

背景

患者体验调查在医疗质量的衡量及提升医疗质量的努力中愈发重要。迄今为止,很少有研究关注医生对给予他们个性化反馈的调查的态度。

目的

本文探讨医生对基层和二级医疗环境中患者体验调查的看法,以加深对医生如何看待此类调查合理性的理解。

设计、背景与参与者:我们在英格兰的两个地区对医生进行了一项定性研究,包括对在基层医疗(n = 21)和二级医疗(n = 20)环境中工作的医生进行深入的半结构化访谈。这两种环境中的医生最近都收到了患者体验调查的个性化反馈。

研究结果

两种环境中的医生都表达了将患者反馈纳入质量改进工作的强烈个人承诺。然而,他们同时也对调查结果的可信度以及患者提供反馈的动机和能力表达了强烈的负面看法。因此,个别医生对患者调查的合理性表现出矛盾的观点,导致对患者反馈的参与复杂、多样且总体上持负面态度。

讨论

医生对患者体验调查的矛盾观点可能会限制此类调查在基层和二级医疗质量改进举措中的影响。我们强调需要开展“意义赋予”举措(即试图通过传达特定的想法、叙述和愿景来影响看法),以使医生就患者体验调查的合理性进行参与。

结论

本研究强调在制定质量改进举措时,考虑医生对患者体验调查看法的重要性。

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