脊柱外科门诊中的患者期望与偏好
Patient Expectations and Preferences in the Spinal Surgery Clinic.
作者信息
Tabibian Borna E, Kuhn Elizabeth N, Davis Matthew C, Pritchard Patrick R
机构信息
Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
出版信息
World Neurosurg. 2017 Oct;106:595-601. doi: 10.1016/j.wneu.2017.07.018. Epub 2017 Jul 14.
BACKGROUND
Managing patient expectations is essential in the treatment of patients undergoing spinal surgery. Patient satisfaction is associated with improved clinical outcomes and can be improved when patient and surgeon expectations are aligned and patient preferences are met.
METHODS
Patients presenting to clinic for management of spinal disease were asked to complete a questionnaire assessing demographics, current pain, reason for visit, and expectations and preferences surrounding the clinic experience. Variables were compared with χ tests to determine factors associated with patient expectations. Subsets of new patients and returning patients were compared by the use of matched pair tests. One-way analysis of variance was used to compare means of clinic expectations in patients depending on their level of education.
RESULTS
A total of 240 patients were included. New patient evaluation was the most common reason for evaluation (26.6%), and pain relief was the most common chief concern (39.3%). Patients preferred their surgeon wash their hands in the room instead of before entering (P < 0.001) and wear professional attire over scrubs (P < 0.001). Patients believe their wait time will be longer than it should be (P = 0.002), they will spend longer in clinic than they should (P = 0.03), and they will get less face-to-face time with their surgeon than they should (P < 0.01) but also that the surgeon is not getting paid enough for the clinic visit (P = 0.02).
CONCLUSIONS
Because spine surgery is largely elective, patients often seek treatment to improve quality of life and alleviate subjective symptoms. Understanding patient expectations is critical to ensure that patients and physicians are working toward similar goals.
背景
在脊柱手术患者的治疗中,管理患者期望至关重要。患者满意度与改善的临床结果相关,当患者和外科医生的期望一致且患者偏好得到满足时,满意度可以提高。
方法
要求前来诊所治疗脊柱疾病的患者完成一份问卷,评估人口统计学特征、当前疼痛情况、就诊原因以及对诊所体验的期望和偏好。使用χ检验比较变量,以确定与患者期望相关的因素。通过配对检验比较新患者和复诊患者的亚组。使用单因素方差分析比较不同教育水平患者对诊所期望的均值。
结果
共纳入240例患者。新患者评估是最常见的评估原因(26.6%),疼痛缓解是最常见的主要关注点(39.3%)。患者更喜欢外科医生在房间内洗手而不是在进入前洗手(P < 0.001),并且更喜欢外科医生穿职业装而不是手术服(P < 0.001)。患者认为他们的等待时间会比应有的更长(P = 0.002),他们在诊所花费的时间会比应有的更长(P = 0.03),他们与外科医生面对面交流的时间会比应有的更少(P < 0.01),但也认为外科医生因门诊就诊获得的报酬不够(P = 0.02)。
结论
由于脊柱手术很大程度上是选择性的,患者通常寻求治疗以改善生活质量并缓解主观症状。了解患者期望对于确保患者和医生朝着相似目标努力至关重要。