患者对结肠镜检查的满意度：内镜医师高估了不良身体症状的重要性。
Patient satisfaction with the colonoscopy procedure: endoscopists overestimate the importance of adverse physical symptoms.
作者信息
Denters Maaike J, Deutekom Marije, Derkx Bert, Bossuyt Patrick M, Fockens Paul, Dekker Evelien
机构信息
Department of Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands.
Department of Social Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
出版信息
Frontline Gastroenterol. 2012 Jul;3(3):130-136. doi: 10.1136/flgastro-2012-100150. Epub 2012 May 6.
BACKGROUND
Colonoscopy is a frequently performed procedure associated with a substantial burden for the patient. Most of what is known about patient satisfaction stems from surveys that target issues doctors believe to be important. It has been noticed that patients often focus on different aspects.
AIM
To have patients and endoscopists rate the extent to which each of a list of patient-generated issues-of-concern contributes to patient satisfaction with the colonoscopy procedure.
SUBJECTS
A sample of consecutive patients undergoing colonoscopy in a Dutch tertiary teaching hospital and a convenience sample of endoscopists.
METHODS
Colonoscopy patients and endoscopists were asked to rate on a five-point Likert scale the importance of 55 items concerning the colonoscopy procedure for patient satisfaction. Items were derived from focus group sessions with colonoscopy patients. Endoscopists were invited to rate the importance of the same set of items from a patient perspective. An analysis was carried out of whether patients and endoscopists rated the importance of items differently.
RESULTS
69 patients and 34 endoscopists completed the questionnaire. The ratings of the endoscopists were significantly different from those of patients (p<0.0001). Endoscopists underestimated the importance of involving patients in decisions, discussing risks and complications, providing the opportunity for substantive questions and offering a comfortable temperature in the examination room. Endoscopists overestimated the importance of adverse physical symptoms, such as pain and abdominal cramps, and the role of the treating doctor.
CONCLUSIONS
Endoscopists do not have a good perception of the items that contribute most to patient satisfaction with the colonoscopy procedure. Overcoming this gap may be an essential step towards improving patient satisfaction by targeting those concerns most relevant to patients.
背景
结肠镜检查是一项经常进行的操作，给患者带来了相当大的负担。目前已知的关于患者满意度的大部分信息来自针对医生认为重要的问题的调查。人们已经注意到，患者往往关注不同的方面。
目的
让患者和内镜医师对一系列由患者提出的关注问题中每一个问题对结肠镜检查患者满意度的影响程度进行评分。
对象
荷兰一家三级教学医院连续接受结肠镜检查的患者样本以及内镜医师的便利样本。
方法
要求结肠镜检查患者和内镜医师用五点李克特量表对55项与结肠镜检查操作相关的影响患者满意度的项目的重要性进行评分。这些项目来自与结肠镜检查患者的焦点小组讨论。邀请内镜医师从患者的角度对同一组项目的重要性进行评分。分析患者和内镜医师对项目重要性的评分是否存在差异。
结果
69名患者和34名内镜医师完成了问卷调查。内镜医师的评分与患者的评分有显著差异（p<0.0001）。内镜医师低估了让患者参与决策、讨论风险和并发症、提供提出实质性问题的机会以及在检查室提供舒适温度的重要性。内镜医师高估了不良身体症状（如疼痛和腹部绞痛）以及主治医生的作用的重要性。
结论
内镜医师对结肠镜检查操作中对患者满意度贡献最大的项目认识不足。通过关注与患者最相关的问题来弥合这一差距可能是提高患者满意度的关键一步。
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