Shahan Charles P, Weinberg Jordan A, Magnotti Louis J, Fabian Timothy C, Croce Martin A
From the Department of Surgery (C.P.S., J.A.W., L.J.M., T.C.F., M.A.C.), University of Tennessee Health Science Center, Memphis, Tennessee.
J Trauma Acute Care Surg. 2016 Dec;81(6):1167-1170. doi: 10.1097/TA.0000000000001140.
Little is known regarding health literacy among trauma patients. Anecdotal experience at our institution has suggested that a profound lack of understanding of basic health care information exists at some level in our patients after hospital discharge. The purpose of this study was to report the results of a pilot quality improvement project to determine trauma patient injury comprehension and how this affects their overall satisfaction with care received.
Trauma patients were surveyed for knowledge of their injuries, operations, and satisfaction with their care at the first outpatient visit following hospital discharge from a Level 1 trauma center.
One hundred seventy-five surveys were distributed and 35 were returned complete and eligible for analysis. Average time from discharge to survey completion was 16 days. Seventy-five percent of patients were male, and the mean age was 37. Fifty-six percent of the injuries were from a blunt mechanism. Seventy-one percent reported household income of less than $25,000 per annum, and 61% had an education level of high school diploma or less. Forty percent of patients were unable to correctly recall their injuries, and 54% were unable to correctly recall operations performed. Seventy-two percent were unable to recall the name of any physician that provided care during their hospital stay. Nonetheless, 90% of patients were at least somewhat satisfied with their injury understanding, and only 3% felt that their level of understanding had a negative impact on their overall satisfaction with care received. There was no correlation between education or income level and ability to correctly recall injuries or operations. In addition, there was no correlation between ability to recall injuries or operations and patients' satisfaction.
The observed deficiency in postdischarge health literacy among our patients is alarming and demonstrates that current hospital discharge education is lacking. Although this deficit did not affect satisfaction with care, we feel a responsibility to improve the health literacy of our patients. The next step at our institution will be to implement a revised discharge education program followed by surveillance to evaluate for improvement.
Therapeutic/care management study, level IV.
关于创伤患者的健康素养，目前所知甚少。我们机构的经验表明，在出院后的患者中，某种程度上存在对基本医疗保健信息的严重理解不足。本研究的目的是报告一项试点质量改进项目的结果，以确定创伤患者对损伤的理解情况以及这如何影响他们对所接受护理的总体满意度。
在一级创伤中心出院后的首次门诊就诊时，对创伤患者进行关于其损伤、手术以及对护理满意度的调查。
共发放了175份调查问卷，35份完整且符合分析条件的问卷被收回。从出院到完成调查的平均时间为16天。75%的患者为男性，平均年龄为37岁。56%的损伤是由钝性机制造成的。71%的患者报告家庭年收入低于25,000美元，61%的患者教育水平为高中文凭或更低。40%的患者无法正确回忆其损伤情况，54%的患者无法正确回忆所进行的手术。72%的患者无法回忆起在住院期间提供护理的任何医生的名字。尽管如此，但90%的患者至少对其对损伤的理解感到有些满意，只有3%的患者认为他们的理解水平对其对所接受护理的总体满意度有负面影响。教育或收入水平与正确回忆损伤或手术的能力之间没有相关性。此外，回忆损伤或手术的能力与患者的满意度之间也没有相关性。
我们观察到患者出院后的健康素养不足令人担忧，这表明当前的出院教育存在缺陷。尽管这种不足并未影响对护理的满意度，但我们感到有责任提高患者的健康素养。我们机构的下一步将是实施修订后的出院教育计划，随后进行监测以评估改进情况。
治疗/护理管理研究，四级。
