Howarth Alison R, Day Sophie, Greene Linda, Ward Helen
Patient Experience Research Centre, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
Jefferiss Wing Centre for Sexual Health, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
BMC Health Serv Res. 2017 May 5;17(1):325. doi: 10.1186/s12913-017-2264-6.
High quality sexual health services are needed to improve both individual and public health outcomes. This study set out to explore what is important to patients who visit a sexual health clinic, and examine their understanding of standard survey questions, in order to inform the collection and interpretation of patient experience data that are used to improve services.
We conducted a cross-sectional, qualitative study. In the first part of the interview, we used "discovery interviews" to explore patients' experiences of attending a central London walk-in sexual health clinic. In the second part, we asked patients how they would respond to eight standard patient experience survey questions and to provide an explanation for each of their responses. We conducted a thematic analysis of the interview data.
We interviewed seventeen participants (nine women, eight men) of different ethnicities and backgrounds. All interviewees were positive about their experience. They described how staff had made them feel "comfortable", and talked about how staff spent time, listened and did not rush them, despite being a very busy clinic. In response to the survey questions, fourteen patients rated their as care excellent or very good overall. However, survey questions were interpreted in different ways and were not always easily understood.
The open-ended "discovery interviews" provided new insights into aspects of care that were most valued or could improve. Standard patient experience questions provide a rating but little elucidation of the experiences that lie behind patients' responses. They do not always measure aspects of care valued by patients or identify areas for improvement. They are not uniformly understood and necessarily collapse a wide range of experiences and views into categories that may seem inappropriate. Qualitative methods have a key role in measuring patient experience and involving patients in service improvement.
需要高质量的性健康服务来改善个人和公共健康状况。本研究旨在探究对于前往性健康诊所就诊的患者而言什么是重要的，并考察他们对标准调查问题的理解，以便为用于改善服务的患者体验数据的收集和解读提供信息。
我们开展了一项横断面定性研究。在访谈的第一部分，我们采用“探索性访谈”来探究患者在伦敦市中心一家无需预约的性健康诊所就诊的经历。在第二部分，我们询问患者他们会如何回答八个标准的患者体验调查问题，并要求他们对每个回答作出解释。我们对访谈数据进行了主题分析。
我们采访了17名来自不同种族和背景的参与者（9名女性，8名男性）。所有受访者对他们的经历都持积极态度。他们描述了工作人员如何让他们感到“舒适”，并谈到尽管诊所非常繁忙，但工作人员如何花时间倾听且不催促他们。对于调查问题，14名患者将他们得到的护理总体评为优秀或非常好。然而，调查问题的解读方式各不相同，且并非总是易于理解。
开放式的“探索性访谈”为最受重视或可改进的护理方面提供了新的见解。标准的患者体验问题提供了一个评分，但对患者回答背后的经历阐释甚少。它们并不总是能衡量患者所重视的护理方面，也无法确定改进的领域。它们并非被一致理解，并且必然会将广泛的经历和观点归纳到可能看似不恰当的类别中。定性方法在衡量患者体验以及让患者参与服务改进方面具有关键作用。
