Thotam Smitha Mary, Buhse Marijean
Int J MS Care. 2020 May-Jun;22(3):129-135. doi: 10.7224/1537-2073.2018-042. Epub 2019 Oct 8.
With the predicted shortage of neurologists, care of patients with multiple sclerosis (MS) may be affected. Nurse practitioners (NPs) have successfully filled the provider gaps in a variety of care settings, with positive effects on care outcomes, including patient satisfaction. The purpose of this study was to determine patient satisfaction with physicians (MDs) and NPs in MS centers.
This is a cross-sectional pilot study wherein a convenience sample was recruited from two MS centers. Demographic data were collected previsit, and satisfaction surveys were completed postvisit using the Patient Satisfaction Questionnaire Short Form (PSQ-18) and the Visit-Specific Satisfaction Instrument (VSQ-9). Different attributes of satisfaction and visit times were analyzed.
Patient satisfaction with both types of providers was high. All attributes of satisfaction were comparable for NPs and MDs, and they spent similar amounts of time with their patients, often exceeding the scheduled office visit duration. Encounter length was a strong determinant of patient satisfaction: VSQ-9 scores were significantly lower ( = .01) when duration was less than 20 minutes. Satisfaction was higher ( = .011) in patients who were diagnosed as having MS for 10 years or longer or had progressive MS, irrespective of provider type.
This pilot study showed that use of standardized questionnaires to determine patient satisfaction with NPs and MDs was feasible. With the impending neurologist shortage and the increased MS prevalence, a collaborative team approach between NPs and MDs may improve access to care in MS centers without compromising patient satisfaction.
鉴于预计神经科医生短缺,多发性硬化症(MS)患者的护理可能会受到影响。执业护士(NPs)已成功填补了各种护理环境中的医疗服务缺口,对护理结果产生了积极影响,包括患者满意度。本研究的目的是确定MS中心患者对医生(MDs)和执业护士的满意度。
这是一项横断面试点研究,从两个MS中心招募了便利样本。在就诊前收集人口统计学数据,并在就诊后使用患者满意度问卷简表(PSQ-18)和特定就诊满意度量表(VSQ-9)完成满意度调查。分析了满意度的不同属性和就诊时间。
患者对这两种医疗服务提供者的满意度都很高。执业护士和医生在所有满意度属性方面相当,他们与患者相处的时间相似,且常常超过预定的门诊时间。就诊时长是患者满意度的一个重要决定因素:当就诊时长少于20分钟时,VSQ-9评分显著更低(P = .01)。被诊断为患有MS达10年或更长时间或患有进展型MS的患者,无论医疗服务提供者类型如何,满意度更高(P = .011)。
这项试点研究表明,使用标准化问卷来确定患者对执业护士和医生的满意度是可行的。鉴于即将出现的神经科医生短缺以及MS患病率的上升,执业护士和医生之间的协作团队方法可能会改善MS中心的医疗服务可及性,而不会影响患者满意度。