Zhumadilova Anara, Craig Brett J, Bobak Martin
Department of Biology, School of Science and Technology, Nazarbayev University, Astana, Kazakhstan.
Department of Health Communication, St. Louis College of Pharmacy, St. Louis, MO.
Ochsner J. 2018 Spring;18(1):46-52.
Health services in Kazakhstan have undergone radical reforms since its independence in 1991, but levels of dissatisfaction among patients remain high. We investigated whether healthcare providers and patients at one hospital in Astana, Kazakhstan, believe the doctor-patient interaction should be doctor-centered vs patient-centered.
We conducted a cross-sectional study of the responses to various surveys of 200 patients (response rate, 74%) and 201 healthcare providers (response rate, 86%) in a general hospital in Astana, Kazakhstan. The participants completed a questionnaire containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Analyses were restricted to those with valid data on the variables age, sex, and PPOS (147 providers and 150 patients).
An overwhelming majority of doctors (80%), nurses (87%), and patients (93%) were doctor-oriented. Among patients, higher patient-oriented scores were statistically significantly associated with higher satisfaction with communication with healthcare providers (=0.038) and with life satisfaction (=0.009).
Only a small percentage of doctors, nurses, and patients reported that their interaction should be patient-centered. This congruence between providers and patients does not explain dissatisfaction, but the finding that patient-centered patients were more satisfied suggests an area for improvement.
哈萨克斯坦自1991年独立以来，其医疗服务经历了彻底改革，但患者的不满程度仍然很高。我们调查了哈萨克斯坦阿斯塔纳一家医院的医疗服务提供者和患者是否认为医患互动应以医生为中心还是以患者为中心。
我们对哈萨克斯坦阿斯塔纳一家综合医院的200名患者（回复率74%）和201名医疗服务提供者（回复率86%）对各种调查的回复进行了横断面研究。参与者完成了一份问卷，其中包含患者-从业者导向量表（PPOS）以及评估生活和工作满意度、工作努力-工作回报平衡和患者沟通评价的量表。分析仅限于那些在年龄、性别和PPOS变量上有有效数据的人（147名提供者和150名患者）。
绝大多数医生（80%）、护士（87%）和患者（93%）都以医生为导向。在患者中，更高的以患者为导向得分与对与医疗服务提供者沟通的更高满意度（=0.038）和生活满意度（=0.009）在统计学上显著相关。
只有一小部分医生、护士和患者表示他们的互动应以患者为中心。提供者和患者之间的这种一致性并不能解释不满，但以患者为中心的患者更满意这一发现表明了一个有待改进的领域。
