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肺部门诊中对患者进行检查和评估的适当最短时长应为多久?

What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics?

作者信息

Musellim Benan, Borekci Sermin, Uzan Gulfidan, Ali Sak Zafer Hasan, Ozdemir Secil Kepil, Altinisik Goksel, Altunbey Sinem Agca, Sen Nazan, Kilinc Oguz, Yorgancioglu Arzu

机构信息

Istanbul University, Cerrahpasa Medical Faculty, Department of Chest Diseases, Istanbul, Turkey.

Haseki Training and Research Hospital, Istanbul, Turkey.

出版信息

Ann Thorac Med. 2017 Jul-Sep;12(3):177-182. doi: 10.4103/atm.ATM_396_16.

Abstract

INTRODUCTION

Patient examinations performed in a limited time period may lead to impairment in patient and physician relationship, defective and erroneous diagnosis, inappropriate prescriptions, less common use of preventive medicine practices, poor patient satisfaction, and increased violent acts against health-care staff.

OBJECTIVE

This study aimed to determine the appropriate minimal duration of patient examination in the pulmonary practice.

METHODS

A total of 49 researchers from ten different study groups of the Turkish Thoracic Society participated in the study. The researchers were asked to examine patients in an almost ideal manner, without time constraint under available conditions.

RESULTS

A total of 1680 patient examinations were reviewed. The mean duration of patient examination in ideal conditions was determined to be 20.4 ± 9.6 min. Among all steps of patient examination, the longest time was spent for "taking medical history." The total time spent for patient examination was statistically significantly longer in the university hospitals than in the governmental hospitals and training and research hospitals ( < 0.001). Among different patient categories, the patients with a chronic disorder presenting for the first time and were referred from primary or secondary to tertiary care for further evaluation have required the longest time for patient examination.

CONCLUSION

According to our study, the appropriate minimal duration for patient examination is 20 min. It has been observed that in university hospitals and in patients with chronic pulmonary diseases, this duration has been increased to above 25 min. The durations in clinical practice should be planned accordingly.

摘要

引言

在有限时间段内进行患者检查可能会导致医患关系受损、诊断缺陷和错误、处方不当、预防医学实践使用较少、患者满意度低以及针对医护人员的暴力行为增加。

目的

本研究旨在确定肺部诊疗中患者检查的合适最短时长。

方法

来自土耳其胸科学会十个不同研究小组的49名研究人员参与了该研究。研究人员被要求在现有条件下以近乎理想的方式检查患者,不受时间限制。

结果

共审查了1680例患者检查。理想条件下患者检查的平均时长确定为20.4±9.6分钟。在患者检查的所有步骤中,“采集病史”花费的时间最长。大学医院患者检查的总时长在统计学上显著长于政府医院以及培训和研究医院(<0.001)。在不同患者类别中,首次出现慢性疾病且从初级或二级转诊至三级医疗机构进行进一步评估的患者检查所需时间最长。

结论

根据我们的研究,患者检查的合适最短时长为20分钟。据观察,在大学医院以及患有慢性肺部疾病的患者中,这一时长已增加至25分钟以上。临床实践中的时长应据此进行规划。

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