Adelaide Medical School, University of Adelaide, Adelaide, SA, 5000, Australia.
Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia.
World J Surg. 2020 Sep;44(9):2950-2958. doi: 10.1007/s00268-020-05561-8.
The importance of the patient experience is increasingly being recognised. However, there is a dearth of studies regarding factors affecting patient-reported outcomes in emergency general surgery (EGS), including none from the Southern Hemisphere. We aim to prospectively assess factors associated with patient satisfaction in this setting.
In this prospective cross-sectional study, all consecutive adult patients admitted to an acute surgical unit over four weeks were invited to complete a validated Patient-Reported Experience Measures questionnaire. These were completed either in person when discharge was imminent or by telephone <4 weeks post-discharge. Responses were used to determine factors associated with overall patient satisfaction.
From 146 eligible patients, 100 (68%) completed the questionnaire, with a mean overall satisfaction score of 8.3/10. On multivariate analyses, eight factors were significantly associated with increased overall satisfaction. Five of these were similar to those previously prescribed by other like studies, being patient age >50 years, sufficient analgesia, satisfaction with the level of senior medical staff, important questions answered by nurses and confidence in decisions made about treatment. Three identified factors were new: sufficient privacy in the emergency department, sufficient notice prior to discharge and feeling well looked after in hospital.
Factors associated with patient satisfaction were identified at multiple points of the patient journey. While some of these have been reported in similar studies, most differed. Hospitals should assess factors valued by their EGS population prior to implementing initiatives to improve patient satisfaction.
患者体验的重要性越来越受到重视。然而,关于影响急诊普通外科(EGS)患者报告结局的因素的研究很少,包括来自南半球的研究。我们旨在前瞻性评估该环境中与患者满意度相关的因素。
在这项前瞻性横断面研究中,邀请在四周内入住急性外科病房的所有连续成年患者完成经过验证的患者报告体验测量问卷。这些问卷要么在即将出院时当面填写,要么在出院后 4 周内通过电话填写。通过这些问卷来确定与总体患者满意度相关的因素。
在 146 名符合条件的患者中,有 100 名(68%)完成了问卷,总体满意度平均得分为 8.3/10。在多变量分析中,有 8 个因素与总体满意度增加显著相关。其中有 5 个因素与其他类似研究中规定的因素相似,即患者年龄>50 岁、足够的镇痛、对高级医务人员水平的满意度、护士回答重要问题和对治疗决策的信心。另外 3 个确定的因素是新的:急诊部门有足够的隐私、在出院前有足够的通知以及在医院得到良好的照顾。
在患者就诊的多个阶段确定了与患者满意度相关的因素。虽然其中一些因素在类似的研究中已经报道过,但大多数因素是不同的。医院在实施提高患者满意度的举措之前,应该评估 EGS 患者群体重视的因素。