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探索患者对其在全科医疗环境中护理体验的反馈的影响及应用——一项实在论综合分析

Exploring the impact and use of patients' feedback about their care experiences in general practice settings-a realist synthesis.

作者信息

Baldie Deborah J, Guthrie Bruce, Entwistle Vikki, Kroll Thilo

机构信息

Centre for Person-centred Practice Research, Division of Nursing, Queen Margaret University, Edinburgh, UK.

NHS Tayside, Ninewells Hospital, Dundee, UK.

出版信息

Fam Pract. 2018 Jan 16;35(1):13-21. doi: 10.1093/fampra/cmx067.

Abstract

BACKGROUND

Policy encourages health care providers to listen and respond to feedback from patients, expecting that it will enhance care experiences. Enhancement of patients' experiences may not yet be a reality, particularly in primary health care settings.

OBJECTIVE

To identify the issues that influence the use and impact of feedback in this context.

DESIGN AND SETTING

A realist synthesis of studies of the use of patient feedback within primary health care settings.

METHODS

Structured review of published studies between 1971 and January 2015.

RESULTS

Eighteen studies were reported in 20 papers. Eleven studies reported patient survey scores as a primary outcome. There is little evidence that formal patient feedback led to enhanced experiences. The likelihood of patient feedback to health care staff stimulating improvements in future patients' experiences appears to be influenced predominantly by staff perceptions of the purpose of such feedback; the validity and type of data that is collected; and where, when and how it is presented to primary health care teams or practitioners and teams' capacity to change.

CONCLUSIONS

There is limited research into how patient feedback has been used in primary health care practices or its usefulness as a stimulant to improve health care experience. Using a realist synthesis approach, we have identified a number of contextual and intervention-related factors that appear to influence the likelihood that practitioners will listen to, act on and achieve improvements in patient experience. Consideration of these may support research and improvement work in this area.

摘要

背景

政策鼓励医疗服务提供者倾听并回应患者反馈,期望这能提升就医体验。然而,提升患者体验可能尚未成为现实,尤其是在初级卫生保健环境中。

目的

确定在此背景下影响反馈使用及效果的问题。

设计与环境

对初级卫生保健环境中患者反馈使用情况的研究进行现实主义综合分析。

方法

对1971年至2015年1月间发表的研究进行结构化综述。

结果

20篇论文报道了18项研究。11项研究将患者调查得分作为主要结果。几乎没有证据表明正式的患者反馈能提升就医体验。患者向医护人员反馈从而促使未来患者体验得到改善的可能性,似乎主要受以下因素影响:工作人员对反馈目的的认知;所收集数据的有效性和类型;以及反馈呈现给初级卫生保健团队或从业者的地点、时间和方式,还有团队的变革能力。

结论

关于患者反馈在初级卫生保健实践中的使用方式及其作为改善就医体验促进因素的有效性的研究有限。通过现实主义综合分析方法,我们确定了一些与背景和干预相关的因素,这些因素似乎会影响从业者倾听、依据反馈采取行动并改善患者体验的可能性。考虑这些因素可能有助于该领域的研究和改进工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb94/6191909/a5991a6ac4e5/cmx06701.jpg

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