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[医疗保健安全:用户代表进行访谈时观察到的住院患者体验与满意度之间的差异]

[Health care safety: The discrepancies between experience and degree of satisfaction of hospitalized patients observed in interviews performed by user representatives].

作者信息

Gross O, Agostini B, Belleval P, Cavé I, Citrini M, Fernandes S, Ghadi M, Graeve N, Gagnayre R

机构信息

Laboratoire Éducations et pratiques de Santé (UR3412), Université Sorbonne Paris Nord, Paris, 74, rue Marcel-Cachin, 93017 Bobigny, France; Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France.

Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France.

出版信息

Rev Epidemiol Sante Publique. 2020 Nov;68(6):337-346. doi: 10.1016/j.respe.2020.10.004. Epub 2020 Nov 6.

DOI:10.1016/j.respe.2020.10.004
PMID:33162268
Abstract

INTRODUCTION

The purpose of this article is to present the results of a qualitative survey conducted by user representatives (URs) focusing on the health care safety experience of hospitalized patients. The authors wished to identify factors associated with safety of care and, more specifically, with the possibly ominous medical events reported by patients.

METHODS

After being trained with these objectives in mind, eight URs conducted semi-directive interviews with fourteen patients hospitalized in eleven separate hospital units in nine different hospitals.

RESULTS

Eight types of factors consisting in 30 contributing factors liable to be reported by patients were identified: 1) factors related to patients' basic needs; 2) personalization of care; 3) professional factors; 4) organizational factors; 5) communication factors; 6) caregiver responsiveness; 7) infectious risks; 8) continuity of care. Patients' overall feelings about their hospitalization remained excellent notwithstanding more tempered, even negative experiences.

CONCLUSION

This paradoxical result shows that the patients' actual experience is far more instructive than their degree of satisfaction. In light of this study, the acceptability of this type of research (i.e. research conducted by URs) is excellent and it also appears highly feasible, whatever the limitations imposed by organizational considerations.

摘要

引言

本文旨在呈现由用户代表开展的一项定性调查结果,该调查聚焦于住院患者的医疗安全体验。作者希望确定与医疗安全相关的因素,更具体地说,是与患者报告的可能不祥的医疗事件相关的因素。

方法

八位用户代表牢记这些目标接受培训后,对九家不同医院11个独立住院科室的14名患者进行了半指导性访谈。

结果

确定了八类共30个可能被患者报告的促成因素:1)与患者基本需求相关的因素;2)个性化护理;3)专业因素;4)组织因素;5)沟通因素;6)护理人员反应能力;7)感染风险;8)连续护理。尽管有更缓和甚至负面的经历,但患者对住院的总体感受仍然很好。

结论

这一矛盾的结果表明,患者的实际体验比他们的满意度更具指导意义。鉴于这项研究,此类研究(即由用户代表开展的研究)的可接受性很高,而且无论组织因素带来何种限制,它似乎也非常可行。

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