Jones C H, O'Neill S, McLean K A, Wigmore S J, Harrison E M
Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.
BMC Surg. 2017 Jul 1;17(1):76. doi: 10.1186/s12893-017-0271-5.
There is a growing recognition of the importance of patient experience in healthcare, however little is known in the context of emergency abdominal surgery. This study sought to quantify the association between patient experience and overall satisfaction.
Patient demographics, operation details and 30-day clinical outcome data of consecutive patients undergoing emergency abdominal surgery were collected. Data was collected using validated Patient Reported Experience Measures (PREMs) questionnaires. Categorical data were tested using Mann Whitney U test. Multivariable regression was used to determine independent factors associated with satisfaction.
In a well-fitting multivariable analysis (R = 0.71), variables significantly associated with a higher global satisfaction score were "sufficient information given about treatment" (β = 0.86, 95% CI 0.01-1.70, p = 0.047), "sufficient explanation of risks and benefits of surgery" (β = 1.26, 95% CI 0.18-2.34, p = 0.020), "absence of night-time noise" (β = 1.35, 95% CI 0.56-2.14, p = 0.001) and "confidence and trust in nurses" (β = 1.51, 95% CI 0.54-2.49, p = 0.003).
Overall patient satisfaction was strongly associated with perceptions of good communication and transfer of information. Confidence and trust in the clinical team is an important determinant of patient experience. Improving the ward environment by reducing noise at night may also improve the overall experience and satisfaction in emergency surgery.
患者体验在医疗保健中的重要性日益受到认可,但在急诊腹部手术方面却知之甚少。本研究旨在量化患者体验与总体满意度之间的关联。
收集接受急诊腹部手术的连续患者的人口统计学资料、手术细节和30天临床结局数据。使用经过验证的患者报告体验测量(PREMs)问卷收集数据。分类数据采用曼-惠特尼U检验。多变量回归用于确定与满意度相关的独立因素。
在一个拟合良好的多变量分析中(R = 0.71),与较高的总体满意度评分显著相关的变量包括“提供了足够的治疗信息”(β = 0.86,95%可信区间0.01 - 1.70,p = 0.047)、“对手术风险和益处进行了充分解释”(β = 1.26,95%可信区间0.18 - 2.34,p = 0.020)、“夜间无噪音”(β = 1.35,95%可信区间0.56 - 2.14,p = 0.001)以及“对护士有信心和信任”(β = 1.51,95%可信区间0.54 - 2.49,p = 0.003)。
患者总体满意度与良好沟通和信息传递的感知密切相关。对临床团队的信心和信任是患者体验的重要决定因素。通过减少夜间噪音来改善病房环境也可能提高急诊手术的总体体验和满意度。