Pelletier Daniel, Green-Demers Isabelle, Collerette Pierre, Heberer Michael
Department of Management, University of Quebec in Outaouais, Gatineau, QC, Canada.
Department of Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada.
SAGE Open Med. 2019 Apr 29;7:2050312119847924. doi: 10.1177/2050312119847924. eCollection 2019.
Although it has long been known that communication with medical professionals presents a strong relationship with patient satisfaction, research on this topic has been hindered by conceptual and methodological issues (e.g. single-item measures, inclusion of idiosyncratic patient characteristics, etc.). Using a more comprehensive and integrated approach, this study had two objectives: to document the multidimensional structure of the Picker Patient Experience-15, and to test a patient communication/satisfaction model that organizes its dimensions in a conceptually logical array of relationships. First, the factorial structure of the Picker Patient Experience-15 was hypothesized to comprise five dimensions: communication with patient, with family, addressing fears/concerns, preparation for discharge, and patient satisfaction. Second, the hypothesized model included positive relationships between all four communications dimensions, on the one hand, and patient satisfaction, on the other. Within communication dimensions, communication with patient was hypothesized to be the incipient factor for other dimensions, and thus to be positively associated with the other three forms of communication.
This research is based on a single time point design, which relied on administrative and questionnaire data. The study was conducted at a large University Hospital in Switzerland. The sample included 54,686 patients who received inpatient treatment, excluding those who were cared for in the intensive and intermediate care units. Patients filled out, over a 5-year period, the Picker Patient Experience questionnaire (PPE-15) after discharge (overall response rate of 41%).
The proposed five-factor structure of the Picker Patient Experience-15 was successfully supported by the results of a confirmatory factor analysis. Moreover, the hypothesized network of associations between communication and satisfaction latent constructs was substantiated using structural equation modeling. With the exception of the association between preparation for discharge and patient satisfaction, the hypothesized model was fully corroborated.
A more in-depth understanding of patient satisfaction can be achieved when it is studied as a multifaceted phenomenon.
尽管长期以来人们都知道与医疗专业人员的沟通与患者满意度密切相关，但该主题的研究一直受到概念和方法问题的阻碍（例如单项测量、纳入特殊患者特征等）。本研究采用更全面和综合的方法，有两个目标：记录Picker患者体验-15的多维结构，并测试一个患者沟通/满意度模型，该模型将其维度组织成概念上逻辑连贯的关系阵列。首先，假设Picker患者体验-15的因子结构包括五个维度：与患者沟通、与家属沟通、解决恐惧/担忧、出院准备和患者满意度。其次，假设模型包括一方面所有四个沟通维度与另一方面患者满意度之间的正相关关系。在沟通维度内，假设与患者沟通是其他维度的起始因素，因此与其他三种沟通形式呈正相关。
本研究基于单一时间点设计，依赖行政和问卷数据。研究在瑞士一家大型大学医院进行。样本包括54686名接受住院治疗的患者，不包括在重症和中级护理病房接受护理的患者。患者在5年期间出院后填写了Picker患者体验问卷（PPE-15）（总体回复率为41%）。
验证性因子分析结果成功支持了所提出的Picker患者体验-15的五因素结构。此外，使用结构方程模型证实了沟通与满意度潜在结构之间假设的关联网络。除了出院准备与患者满意度之间的关联外，假设模型得到了充分证实。
将患者满意度作为一个多方面的现象进行研究，可以更深入地理解它。
