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骨科诊所中患者与医生对医疗护理认知的一致性

Concordance of Patient and Physician Perceptions of Care in an Orthopedic Clinic.

作者信息

Zhang Kelly, Day Charles, Iorio Matthew L

出版信息

Orthopedics. 2017 Jul 1;40(4):242-246. doi: 10.3928/01477447-20170418-05. Epub 2017 Apr 24.

Abstract

It is essential to study whether physicians' perceptions align with their patients' views, as understanding patient perception leads to superior satisfaction and health outcomes. Previous studies have established differences in physician-patient perceptions, but no studies have been conducted in orthopedic clinics. The authors' primary goal was to evaluate differences in physician and patient perceptions of an orthopedic clinic visit. Their secondary objective was to determine the influence of visit length, demographics, and depression risk-level on patient satisfaction. The authors surveyed 143 new patients being seen by orthopedic surgeons at a level I trauma center. After their appointment, these patients completed surveys on satisfaction and likelihood of depression. The authors recorded wait times and visit lengths. Simultaneously, the physicians completed a self-evaluative satisfaction survey. Patients' and physicians' answers were compared using a Wilcoxon signed-rank test. Mann-Whitney and Spearman correlation analyses were used to assess factors that impact satisfaction. Physicians and patients showed no significant differences on most questions of the satisfaction survey, except that physicians reported feeling less satisfied with their own explanations (P<.001). Length of visit was positively correlated with patient satisfaction (R=0.276, P=.001), while waiting times had no effect. Patients at risk for depression were less satisfied with physicians' effort to include them in decision-making (P=.044). Age was a predictor of greater satisfaction with explanations (P=.032) and instructions (P=.009) from the physician. Thus, orthopedic clinics may not exhibit the same physician-patient perception patterns as primary care clinics, potentially because of differences in patient populations, conditions, or expectations. [Orthopedics. 2017; 40(4):242-246.].

摘要

研究医生的认知与患者的观点是否一致至关重要,因为了解患者的认知会带来更高的满意度和更好的健康结果。以往的研究已经证实了医患认知存在差异,但尚未在骨科诊所进行过相关研究。作者的主要目标是评估医生和患者对骨科门诊就诊的认知差异。其次要目标是确定就诊时长、人口统计学特征和抑郁风险水平对患者满意度的影响。作者对一家一级创伤中心的骨科外科医生诊治的143名新患者进行了调查。预约就诊后,这些患者完成了关于满意度和抑郁可能性的调查。作者记录了等待时间和就诊时长。同时,医生完成了一份自我评估的满意度调查。使用Wilcoxon符号秩检验比较患者和医生的答案。采用Mann-Whitney和Spearman相关性分析来评估影响满意度的因素。在满意度调查的大多数问题上,医生和患者没有显著差异,只是医生报告对自己的解释不太满意(P<0.001)。就诊时长与患者满意度呈正相关(R=0.276,P=0.001),而等待时间没有影响。有抑郁风险的患者对医生在决策过程中让他们参与的努力不太满意(P=0.044)。年龄是对医生的解释(P=0.032)和指示(P=0.009)满意度更高的一个预测因素。因此,骨科诊所可能不会呈现出与初级保健诊所相同的医患认知模式,这可能是由于患者群体、病情或期望的差异所致。[《骨科》。2017年;40(4):242 - 246。]

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