Shiber Shachaf, Zuker-Herman Rona, Drescher Michael J, Glezerman Marek
The Department of Emergency Medicine, Rabin Medical Center, Beilinson Campus, 49100, Petach-Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
Isr J Health Policy Res. 2018 Sep 18;7(1):50. doi: 10.1186/s13584-018-0245-9.
Previous studies have shown that, in a variety of health care settings, patients often do not understand what health care professionals tell them about their diagnoses and care plans; this is particularly true among male patients. Emergency department (ED) settings present unique challenges to communication with patients due to the rapid pace of activity, substantial changes in personnel over the course of the day and the week, and the need for fast decision-making processes. The aim of our study was to investigate the extent to which patients in an Israeli ED comprehended their plan of care and whether there were gender differences in this regard.
We conducted a questionnaire-based prospective study, in which patients admitted to the ED at Rabin Medical Center were evaluated during the years 2014-2016. The primary outcome was patients' comprehension of their plan of care, stratified by gender of patients. Plan of care included information related to diagnosis, treatment and discharge instructions. The secondary outcome was patients' satisfaction with the instruction process.
One hundred seventy seven ED patients met study criteria and were asked to participate in the study; 85% of them agreed to do so. Overall, 150 ED patients aged 18-80 were recruited [75 men (50%) and 75 women (50%)]. 80% of the respondents reported a satisfactory understanding of their plan of care. Overall, no gender-related differences were found. Differences between men and women concerning satisfaction with the instructions provided by nurses were found among non-Hebrew speakers, but not among Hebrew speakers.
Contrary to most earlier studies, patients at our ED demonstrated a high degree of self-reported adequate comprehension concerning their plan of care, and overall no gender-related differences were found. These finding may be due in part to improved training of the medical staff to better communicate with the patients and to answer their questions. In addition, patients may feel more comfortable than in the past about asking the medical staff questions regarding their plan of care and diagnosis. The main implication of this study is that physician education programs should continue to emphasize patient-physician communications skills and improving methods for providing patients with information.
先前的研究表明，在各种医疗环境中，患者常常不理解医护人员告知他们的诊断结果和护理计划；男性患者尤其如此。急诊科的环境给与患者沟通带来了独特的挑战，这是由于工作节奏快、一天及一周内人员变动大以及需要快速做出决策。我们研究的目的是调查以色列一家急诊科的患者对其护理计划的理解程度，以及在这方面是否存在性别差异。
我们进行了一项基于问卷调查的前瞻性研究，在2014年至2016年期间对拉宾医疗中心急诊科收治的患者进行评估。主要结果是患者对其护理计划的理解情况，按患者性别分层。护理计划包括与诊断、治疗和出院指导相关的信息。次要结果是患者对指导过程的满意度。
177名急诊科患者符合研究标准并被邀请参与研究；其中85%同意参与。总体而言，招募了150名年龄在18至80岁之间的急诊科患者[75名男性（50%）和75名女性（50%）]。80%的受访者表示对其护理计划有满意的理解。总体而言，未发现与性别相关的差异。在非希伯来语使用者中发现了男性和女性在对护士提供的指导满意度方面的差异，但在希伯来语使用者中未发现。
与大多数早期研究相反，我们急诊科的患者自我报告对其护理计划有高度的充分理解，总体上未发现与性别相关的差异。这些发现可能部分归因于医护人员培训的改进，使其能更好地与患者沟通并回答他们的问题。此外，患者可能比过去更愿意就其护理计划和诊断向医护人员提问。本研究的主要启示是，医生教育项目应继续强调医患沟通技巧，并改进向患者提供信息的方法。
