Boinon Diane, Dauchy Sarah, Charles Cecile, Fasse Léonor, Cano Alejandra, Balleyguier Corinne, Mazouni Chafika, Caron Hélène, Vielh Philippe, Delaloge Suzette
Psycho-Oncology Unit, Gustave Roussy, Paris-Saclay University, Villejuif, France.
Paris Descartes University (LPPS), Paris, France.
Breast J. 2018 Mar;24(2):154-160. doi: 10.1111/tbj.12856. Epub 2017 Jul 13.
Few studies have explored with standard measures patient satisfaction with care at the time of the diagnosis through rapid diagnostic pathways. This study aimed to assess satisfaction levels at the time of the diagnosis in a One-Stop Breast Unit and to examine associations with psychological states. An anonymous cross-sectional survey was conducted at a single center's One-Stop Breast Unit, to assess patient satisfaction regarding several aspects of the Unit. Two days after the diagnosis, 113 participants completed self-reported questionnaires evaluating satisfaction (Out-Patsat35), anxiety (State Anxiety Inventory), and psychological distress (Distress Thermometer). Overall, patients were very satisfied (80.7±20.7) with the One-Stop Breast Unit. The highest mean satisfaction scores concerned nurses' technical skills, interpersonal skills and availability. The lowest mean scores concerned physicians' availability, waiting time, and the provision of information. The results revealed a significant association between high state anxiety levels, lower levels of satisfaction with doctors' interpersonal skills (r=-.41, P<.001) and lower levels for information provided by nurses (r=-.38, P<.001). Moreover, greater psychological distress was associated with less satisfaction with the different aspects of care (doctors' interpersonal skills, doctors' availability and waiting-time). The results of regression models showed that doctor-related satisfaction scales explained 20% of the variance in anxiety (P<.01). Facing cancer diagnosis remains a stressful situation. However, our study suggested that a substantial part of this anxiety is sensitive to the quality of the patient-doctor relationship. Consequently, further efforts should be expended on adapting patient-doctor communication to improve patient reassurance.
很少有研究使用标准方法来探究患者通过快速诊断途径在确诊时对医疗护理的满意度。本研究旨在评估一站式乳腺科在确诊时的满意度水平,并研究其与心理状态的关联。在一个单一中心的一站式乳腺科进行了一项匿名横断面调查,以评估患者对该科室几个方面的满意度。确诊两天后,113名参与者完成了自我报告问卷,评估满意度(门诊患者满意度量表35项)、焦虑(状态焦虑量表)和心理困扰(苦恼温度计)。总体而言,患者对一站式乳腺科非常满意(80.7±20.7)。平均满意度得分最高的方面涉及护士的技术技能、人际技能和可及性。平均得分最低的方面涉及医生的可及性、等待时间和信息提供。结果显示,高状态焦虑水平与对医生人际技能的较低满意度(r = -0.41,P < 0.001)以及护士提供信息的较低满意度(r = -0.38,P < 0.001)之间存在显著关联。此外,更大的心理困扰与对护理不同方面(医生人际技能、医生可及性和等待时间)的较低满意度相关。回归模型结果表明,与医生相关的满意度量表解释了焦虑变异的20%(P < 0.01)。面对癌症诊断仍然是一种压力很大的情况。然而,我们的研究表明,这种焦虑的很大一部分对医患关系质量敏感。因此,应进一步努力调整医患沟通以提高患者的安心程度。