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养老院老年人对医患关系的认知及对全科医生护理的满意度

Perceived doctor-patient relationship and satisfaction with general practitioner care in older persons in residential homes.

作者信息

de Waard Claudia S, Poot Antonius J, den Elzen Wendy P J, Wind Annet W, Caljouw Monique A A, Gussekloo Jacobijn

机构信息

a Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands.

出版信息

Scand J Prim Health Care. 2018 Jun;36(2):189-197. doi: 10.1080/02813432.2018.1459229. Epub 2018 Apr 12.

Abstract

OBJECTIVE

Understanding patient satisfaction from the perspective of older adults is important to improve quality of their care. Since patient and care variables which can be influenced are of specific interest, this study examines the relation between patient satisfaction and the perceived doctor-patient relationship in older persons and their general practitioners (GPs).

DESIGN

Cross-sectional survey.

SUBJECTS AND SETTING

Older persons (n = 653, median age 87 years; 69.4% female) living in 41 residential homes.

MAIN OUTCOME MEASURES

Patient satisfaction (report mark) and perceived doctor-patient relationship (Leiden Perioperative care Patient Satisfaction questionnaire); relationships were examined by comparing medians and use of regression models.

RESULTS

The median satisfaction score was 8 (interquartile range 7.5-9; range 0-10) and doctor-patient relationship 65 (interquartile range 63-65; range 13-65). Higher satisfaction scores were related to higher scores on doctor-patient relationship (Jonckheere Terpstra test, p for trend <.001) independent of gender, age, duration of stay in the residential home, functional and clinical characteristics. Adjusted for these characteristics, per additional point for doctor-patient relationship, satisfaction increased with 0.103 points (β = 0.103, 95% CI 0.092-0.114; p < .001). In those with a 'low' doctor-patient relationship rating, the percentage awarding 'sufficient or good' to their GP for 'understanding about the personal situation' was 12%, 'receiving attention as an individual' 22%, treating the patient kindly 78%, and being polite 94%.

CONCLUSION

In older persons, perceived doctor-patient relationship and patient satisfaction are related, irrespective of patient characteristics. GPs may improve patient satisfaction by focusing more on the affective aspects of the doctor-patient relationship. Key Points Examination of the perceived doctor-patient relationship as a variable might better accommodate patients' expectations and improve satisfaction with the provided primary care.

摘要

目的

从老年人的角度了解患者满意度对于提高其护理质量很重要。由于那些可能受到影响的患者和护理变量具有特殊意义,本研究探讨了老年人及其全科医生(GP)的患者满意度与感知到的医患关系之间的关系。

设计

横断面调查。

研究对象与研究地点

居住在41所养老院的老年人(n = 653,中位年龄87岁;女性占69.4%)。

主要观察指标

患者满意度(报告评分)和感知到的医患关系(莱顿围手术期护理患者满意度问卷);通过比较中位数和使用回归模型来研究两者之间的关系。

结果

满意度评分中位数为8(四分位间距7.5 - 9;范围0 - 10),医患关系评分为65(四分位间距63 - 65;范围13 - 65)。更高的满意度评分与更高的医患关系评分相关(琼克尔-特普斯特拉检验,趋势p <.001),且不受性别、年龄、在养老院的居住时间、功能和临床特征的影响。在对这些特征进行调整后,医患关系评分每增加1分,满意度增加0.103分(β = 0.103,95%置信区间0.092 - 0.114;p <.001)。在医患关系评级为“低”的人群中,对于全科医生在“了解个人情况”方面给予“足够或良好”评价的比例为12%,在“作为个体受到关注”方面为22%,在“亲切对待患者”方面为78%,在“礼貌待人”方面为94%。

结论

在老年人中,感知到的医患关系与患者满意度相关,与患者特征无关。全科医生可以通过更多地关注医患关系的情感方面来提高患者满意度。要点 将感知到的医患关系作为一个变量进行研究可能更好地满足患者的期望,并提高对所提供初级护理的满意度。

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