Dyer T A, Owens J, Robinson P G
Dental Public Health, University of Sheffield, Sheffield, UK.
Oral and Dental Sciences, University of Bristol, Bristol, UK.
Community Dent Health. 2016 Dec;33(4):242-251. doi: 10.1922/CDH_3902Dyer10.
The assessment of healthcare quality increasingly emphasises lay acceptability, as evidenced by the emergence of patient satisfaction and patient-centred care in the literature and in policy. In this paper we aim to provide a conceptual overview of acceptability and propose ways to enhance its assessment. Firstly, we map how acceptability's importance in quality assessments has increased and how the term acceptability has been used as synonymous with patient satisfaction, despite it being a broader concept. We then critique the concept of patient satisfaction and its measurement and challenge its use as an indicator of acceptability and quality. By drawing on our research and those of others, the second half of the paper describes how trust in clinicians and health services has emerged as a related concept, including a theoretical discussion of trust in healthcare outlining how it can be built, undermined and abused. We propose trust as an alternative indicator of acceptability in healthcare quality and review its measurement. Finally, we consider how healthcare policy may impact on trust and make recommendations for future research.
医疗质量评估越来越强调外行的可接受性，文献和政策中出现的患者满意度和以患者为中心的护理就证明了这一点。在本文中，我们旨在提供一个关于可接受性的概念性概述，并提出提高其评估的方法。首先，我们梳理了可接受性在质量评估中的重要性是如何增加的，以及尽管可接受性是一个更广泛的概念，但它是如何被用作患者满意度的同义词的。然后，我们对患者满意度的概念及其测量进行了批判，并质疑其作为可接受性和质量指标的用途。通过借鉴我们自己和其他人的研究，本文后半部分描述了对临床医生和医疗服务的信任是如何作为一个相关概念出现的，包括对医疗保健中信任的理论讨论，概述了信任是如何建立、被破坏和被滥用的。我们建议将信任作为医疗质量可接受性的替代指标，并对其测量进行综述。最后，我们考虑医疗政策可能如何影响信任，并为未来的研究提出建议。
