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从患者视角看:慢性病护理的安全性。

Seen through the patients' eyes: Safety of chronic illness care.

作者信息

Desmedt Melissa, Petrovic Mirko, Bergs Jochen, Vandijck Dominique, Vrijhoef Hubertus, Hellings Johan, Vermeir Peter, Cool Lieselot, Dessers Ezra

机构信息

Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Building D, 3590 Diepenbeek, Belgium.

Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Gent, Belgium.

出版信息

Int J Qual Health Care. 2017 Nov 1;29(7):916-921. doi: 10.1093/intqhc/mzx137.

Abstract

OBJECTIVE

Due to the increasing burden of chronic diseases, a considerable part of care delivery will continue to shift from secondary to primary care, and home care settings. Despite the growing importance of primary care, concerns about the safety of patients in hospitals have thus far driven most research in the field. Therefore, the present study sought to explore patients' perceptions and experiences of the safety of primary chronic care.

DESIGN

An observational, cross-sectional study design was applied.

PARTICIPANTS

Participants were recruited from the Flemish Patients' Platform, an independent organization that defends patients' rights and strives for more care quality.

MAIN OUTCOME MEASURE(S): An online questionnaire was designed to assess: socio-demographic characteristics, medical consumption and patients' perspectives of the quality and safety of chronic care.

RESULTS

Respondents (n = 339) had positive perceptions of the safety of primary chronic care as they indicated to receive safe care at home (68.1%), receive enough care support at home (70.8%) and experience good communication between their healthcare professionals (51.6%). Almost one quarter of respondents experienced an incident, mainly related to self-reported fall incidents (50.4%), wrong diagnoses or treatments (37.8%) and adverse drug events (11.8%). Also, more than half of respondents who experienced an incident (64.9%) indicated that poor communication between their healthcare professionals was the main cause.

CONCLUSIONS

Information on patients' experiences is critical to identify patient safety incidents and to ultimately reduce patient harm. More research is needed to fully understand patient safety in primary chronic care to further improve patient safety.

摘要

目的

由于慢性病负担日益加重,相当一部分医疗服务将继续从二级医疗转向初级医疗和家庭护理环境。尽管初级医疗的重要性日益凸显,但迄今为止,对医院患者安全的担忧推动了该领域的大部分研究。因此,本研究旨在探讨患者对初级慢性病护理安全性的看法和体验。

设计

采用观察性横断面研究设计。

参与者

参与者从佛兰芒患者平台招募,该平台是一个捍卫患者权利并努力提高护理质量的独立组织。

主要结局指标

设计了一份在线问卷,以评估:社会人口学特征、医疗消费以及患者对慢性病护理质量和安全性的看法。

结果

受访者(n = 339)对初级慢性病护理的安全性持积极看法,因为他们表示在家中接受安全护理(68.1%)、在家中获得足够的护理支持(70.8%)以及体验到医护人员之间良好的沟通(51.6%)。近四分之一的受访者经历过事件,主要与自我报告的跌倒事件(50.4%)、错误诊断或治疗(37.8%)以及药物不良事件(11.8%)有关。此外,经历过事件的受访者中,超过一半(64.9%)表示医护人员之间沟通不畅是主要原因。

结论

有关患者体验的信息对于识别患者安全事件并最终减少患者伤害至关重要。需要更多研究来全面了解初级慢性病护理中的患者安全,以进一步提高患者安全。

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