Department of Surgery, Yale School of Medicine, New Haven, CT.
Department of Surgery, Yale School of Medicine, New Haven, CT.
J Am Coll Surg. 2018 Jun;226(6):1022-1029. doi: 10.1016/j.jamcollsurg.2018.03.037. Epub 2018 Apr 12.
The common practice of performing concurrent or overlapping operations has been intensely scrutinized by lay media and academic press to investigate its safety and cost-effectiveness. However, there is little information about its use within the pediatric population. Even less is known about parents' expectations about the surgeon's role on the day of operation and how they align with those of pediatric surgeons and surgical trainees, despite the potential for significant discrepancies in expectations to erode trust and damage the physician-family relationship.
A 5-point Likert-style survey was designed to characterize expectations about the degree of involvement by pediatric attending surgeons throughout a surgical case (1 = strongly disagree, 3 = neutral, 5 = strongly agree). The survey was administered to parents of pediatric patients undergoing elective operations during a 3-month interval at a single academic institution. The survey was also administered to surgeons and surgical residents at the same institution. Multivariate multiplicity-adjusted t-tests were used to identify significant differences between responders.
One hundred and ten parents and 84 pediatric surgeons and trainees completed the survey. Parents' responses to the survey ranged from 4.15 to 4.89, compared with 2.75 to 4.86 from surgeons. The differences achieved statistical significance (p < 0.05) for 8 of 9 statements. Statistically significant differences were fewer, but still present, between attending surgeons and surgical trainees, as well as between surgeons with and without children.
There is a significant mismatch between parents' expectations and those of pediatric surgeons about the role of the surgeon on the day of operation, with parents consistently expecting more direct involvement by the attending surgeon. These discrepancies can have implications for both parent/patient satisfaction and medical education.
同时或重叠进行手术的常见做法受到了大众媒体和学术媒体的严格审查，以调查其安全性和成本效益。然而，关于其在儿科人群中的使用情况，信息很少。尽管期望的差异可能会削弱信任并破坏医患关系，但关于父母对手术当天外科医生角色的期望以及它们与儿科外科医生和外科住院医师的期望如何一致的信息知之甚少。
设计了 5 点李克特式量表来描述儿科主治外科医生在整个手术过程中参与程度的期望（1=强烈不同意，3=中立，5=强烈同意）。该调查在一家学术机构对接受择期手术的儿科患者的父母进行了为期 3 个月的调查。该调查还向同一机构的外科医生和住院医师进行了调查。使用多元多重调整 t 检验来识别应答者之间的显著差异。
110 名父母和 84 名儿科外科医生和住院医师完成了调查。父母对调查的答复范围从 4.15 到 4.89，而外科医生的答复范围从 2.75 到 4.86。8 个陈述中有 8 个达到了统计学意义（p<0.05）。主治外科医生和外科住院医师之间以及有子女和无子女的外科医生之间的差异虽然较少，但仍然存在。
父母对手术当天外科医生角色的期望与儿科外科医生的期望之间存在显著不匹配，父母始终期望主治外科医生更直接地参与。这些差异可能对父母/患者满意度和医学教育都有影响。
