International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
BMC Health Serv Res. 2019 Jan 8;19(1):17. doi: 10.1186/s12913-018-3857-4.
Patient satisfaction is an important measure of quality of care and a determinant of health service utilisation and the choice of health facility. Measuring patients' experiences is important for understanding and improving the quality of care at health facilities. The aim of this study was to assess levels and identify associated factors of caregivers' satisfaction and provider-caregiver communication within child healthcare in Nepal.
Secondary analysis of Sick Child Exit Interviews (n = 2092) sourced from 2015 Nepal Health Facility Survey data. Satisfaction was measured through caregivers' satisfaction with services received and their willingness to recommend the health facility visited. Communication indicators were chosen based on the 2014 WHO IMCI guidelines and aggregate communication scores were calculated based on the number of indicators acknowledged during assessments. Logistic regression was used for analysis.
Although most respondents (82.1%) reportedly were satisfied with the care provided, only 35.9% experienced good communication with their providers. Caregivers who had ever attended school were more likely to be satisfied with services (1.44, CI 95% 1.04-1.99). Type of provider, sex of child or who the caregiver was had no association with caregivers' satisfaction. Having been given a diagnosis doubled the chances of satisfaction (AOR 2.04, 95% CI 1.38-3.00), as did discussion of the child's growth (OR 1.71, 95% CI 1.06-2.76) and having discussed any of the included topics (AOR 1.98, CI 95% 1.14-3.45).
Interventions to improve healthcare staff's communication skills are needed in Nepal to further enhance satisfaction with services and increase quality of care. However, this is an area that need further investigation given the high levels of satisfaction displayed despite poor communication. Other factors in the health care exchange between provider and clients are influencing the level of satisfaction and need to be identified and promoted further. High-quality care is no longer a goal for the future or only for high income settings; it is essential for reaching global health goals.
患者满意度是医疗服务质量的重要衡量标准，也是影响卫生服务利用和医疗机构选择的决定因素。评估患者体验对于了解和改善医疗机构的医疗质量至关重要。本研究旨在评估尼泊尔儿童保健中护理人员满意度及其与医护人员沟通的相关因素。
对 2015 年尼泊尔卫生设施调查数据中 2092 名儿童就诊结束时的访谈（Sick Child Exit Interviews，SCEI）进行二次分析。满意度通过护理人员对所接受服务的满意度以及对所就诊医疗机构的推荐意愿来衡量。沟通指标基于 2014 年世界卫生组织儿童疾病综合管理（IMCI）指南选择，根据评估期间确认的指标数量计算综合沟通评分。采用逻辑回归进行分析。
尽管大多数受访者（82.1%）表示对所提供的护理服务满意，但仅有 35.9%的受访者表示与医护人员沟通良好。曾经接受过学校教育的护理人员更有可能对服务感到满意（1.44，95%CI 1.04-1.99）。医护人员的类型、儿童的性别或护理人员的身份与护理人员的满意度无关。获得诊断的受访者满意度增加一倍（AOR 2.04，95%CI 1.38-3.00），讨论儿童生长情况的受访者满意度增加 1.71 倍（OR 1.71，95%CI 1.06-2.76），讨论了任何包括的话题的受访者满意度增加 1.98 倍（AOR 1.98，95%CI 1.14-3.45）。
尼泊尔需要开展提高医疗保健工作人员沟通技巧的干预措施，以进一步提高对服务的满意度并提高医疗质量。然而，鉴于沟通不佳的情况下满意度却很高，这是一个需要进一步调查的领域。在提供者和客户之间的医疗保健交流中，其他因素也会影响满意度水平，需要进一步确定和促进。高质量的医疗保健不再是未来的目标，也不仅仅是高收入国家的目标；它是实现全球卫生目标的必要条件。
