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简短心理社会干预对住院患者满意度的影响:一项随机对照试验。

Effects of a Brief Psychosocial Intervention on Inpatient Satisfaction: A Randomized Controlled Trial.

作者信息

Pace Emma J, Somerville Nicholas J, Enyioha Chineme, Allen Joseph P, Lemon Latrina C, Allen Claudia W

机构信息

University of Virginia Department of Family Medicine.

出版信息

Fam Med. 2017 Oct;49(9):675-678.

Abstract

BACKGROUND AND OBJECTIVES

Increasing attention is being paid to patients’ experience of hospitalization. BATHE (a brief psychosocial intervention that addresses Background, Affect, Trouble, Handling, and Empathy) has been found to improve patients’ outpatient experiences but has not yet been studied in inpatient settings. This randomized controlled trial (RCT) examined whether daily administration of BATHE would improve patients’ satisfaction with their hospital experience.

METHODS

BATHE is a brief psychosocial intervention designed to reduce distress and strengthen the physician-patient relationship. In February through March 2015 and February through March 2016, 25 patients admitted to the University of Virginia Family Medicine inpatient service were randomized to usual care or to the BATHE intervention. Participants completed a baseline measure of satisfaction at enrollment. Those in the intervention group received the BATHE intervention daily for five days or until discharge. At completion, participants completed a patient satisfaction measure.

RESULTS

Daily administration of BATHE had strong effects on patients’ likelihood of endorsing their medical care as “excellent.” BATHE did not improve satisfaction by making patients feel more respected, informed or attended to. Rather, effects on satisfaction were mediated by patients’ perception that their physician showed “a genuine interest in me as a person."

CONCLUSIONS

Our study suggests that patients are more satisfied with their hospitalization experience when physicians take a daily moment to check in with the patient “as a person” and not just as a medical patient. The brevity of the BATHE intervention indicates that this check-in need not be lengthy or overly burdensome for the already busy inpatient physician.

摘要

背景与目的

患者的住院体验日益受到关注。BATHE(一种针对背景、情感、困扰、应对及同理心的简短心理社会干预方法)已被证实可改善患者的门诊体验,但尚未在住院环境中进行研究。这项随机对照试验(RCT)旨在探究每日实施BATHE是否会提高患者对住院体验的满意度。

方法

BATHE是一种简短的心理社会干预方法,旨在减轻患者痛苦并加强医患关系。在2015年2月至3月以及2016年2月至3月期间,弗吉尼亚大学家庭医学住院部收治的25名患者被随机分为常规护理组或BATHE干预组。参与者在入组时完成了一份满意度基线测量。干预组的患者连续五天每日接受BATHE干预,直至出院。结束时,参与者完成了一项患者满意度测量。

结果

每日实施BATHE对患者将其医疗护理评价为“优秀”的可能性有显著影响。BATHE并非通过让患者感觉更受尊重、信息更充分或得到更多关注来提高满意度。相反,对满意度的影响是由患者认为医生“真正关心我这个人”的认知所介导的。

结论

我们的研究表明,当医生每天花时间“作为一个人”而非仅仅作为医疗患者与患者交流时,患者对住院体验会更满意。BATHE干预的简短性表明,这种交流对本就忙碌的住院医生来说无需冗长或负担过重。

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