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患者对决策的满意度与外科医生以患者为中心的程度不相关。

Patient Satisfaction With Decision Making Does Not Correlate With Patient Centeredness of Surgeons.

机构信息

Department of Surgery, University of Utah, Salt Lake City, Utah.

Department of Surgery, University of Utah, Salt Lake City, Utah.

出版信息

J Surg Res. 2020 Feb;246:411-418. doi: 10.1016/j.jss.2019.09.028. Epub 2019 Oct 18.

Abstract

BACKGROUND

High-quality decision making is important in patient-centered care. Although patient involvement in decision making varies widely, most patients desire to share in decision making. The Press-Ganey Patient Satisfaction survey includes questions that measure patients' perceptions of their providers' efforts to involve them in decision making (PGDM). We hypothesized that higher PGDM scores would correlate with higher scores on a validated measure of patient centeredness.

MATERIALS AND METHODS

Surgical providers at a university hospital who routinely receive Press-Ganey scores received a survey that included the Patient-Practitioner Orientation Scale (PPOS), a validated tool that measures the provider's orientation toward patient centeredness on a continuous six-point scale: score ≥5 = high, 4.57-5 = moderate, and <4.57 = low and includes nine-item "caring" or "sharing" subscales. We compared PPOS scores to PGDM scores, averaged from April 2015 to January 2016.

RESULTS

Eighty-six of 112 (75%) of surgical providers responded to the survey. Fifty-two (46%) had PGDM scores available and 26% achieved a perfect score on the PGDM. The overall PPOS scores were low, with a mean of 4.2 (SD = 0.5). The PPOS was not correlated with the PGDM, correlation coefficient (r) = -0.07 (CI: -0.34-0.21, P = 0.63). Similarly, the two subscales of the PPOS did not correlate with the PGDM with r = -0.15 (CI: -0.41-0.13, P = 0.29) for "caring" and r = -0.04 (CI: -0.31-0.23, P = 0.76) for "sharing".

CONCLUSIONS

Although surgical providers scored low in patient centeredness using the PPOS, over one-quarter (26%) of them rank in the top 1% on the PGDM. No correlation was found between providers' patient centeredness and their patients' perceptions of efforts to include them in decision making.

摘要

背景

高质量的决策在以患者为中心的护理中很重要。尽管患者参与决策的程度差异很大,但大多数患者都希望参与决策。盖洛普患者满意度调查(Press-Ganey Patient Satisfaction survey)包括衡量患者对提供者在决策中努力让其参与的看法的问题(PGDM)。我们假设较高的 PGDM 评分与经过验证的患者为中心的测量评分较高相关。

材料与方法

一家大学医院的外科医生,他们通常会收到盖洛普评分(Press-Ganey scores),他们收到了一份调查,其中包括患者医生取向量表(Patient-Practitioner Orientation Scale,PPOS),这是一种经过验证的工具,用于衡量提供者在连续六分制上对患者为中心的取向:得分≥5=高,4.57-5=中等,<4.57=低,包括九个“关怀”或“分享”子量表。我们将 PPOS 评分与 2015 年 4 月至 2016 年 1 月的平均 PGDM 评分进行了比较。

结果

112 名外科医生中有 86 名(75%)对调查做出了回应。52 名(46%)有 PGDM 评分,26%的人在 PGDM 上获得了完美评分。PPOS 的总体评分较低,平均得分为 4.2(SD=0.5)。PPOS 与 PGDM 不相关,相关系数(r)=-0.07(CI:-0.34-0.21,P=0.63)。同样,PPOS 的两个子量表与 PGDM 不相关,r=-0.15(CI:-0.41-0.13,P=0.29),“关怀”r=-0.04(CI:-0.31-0.23,P=0.76),“分享”。

结论

尽管外科医生在使用 PPOS 时在患者为中心方面得分较低,但他们中有四分之一(26%)在 PGDM 中排名前 1%。没有发现提供者的患者为中心与患者对参与决策的看法之间存在相关性。

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