Organizational Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstr. 140, 26129 Oldenburg, Germany.
Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany.
Int J Environ Res Public Health. 2021 Aug 3;18(15):8224. doi: 10.3390/ijerph18158224.
(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization in hospitals is associated with breast cancer patients' perceived social support from nurses.; (2) Methods: Data analysis based on a cross-sectional patient survey (2979 breast cancer patients, 83 German hospitals) and information on hospital structures. Associations between process organization and perceived social support were analyzed with logistic hierarchical regression models adjusted for patient characteristics and hospital structures.; (3) Results: Most patients were 40-69 years old and classified with UICC stage II or III. Native language, age and hospital ownership status showed significant associations to the perception of social support. Patients treated in hospitals with better process organization at admission (OR 3.61; 95%-CI 1.67, 7.78) and during the hospital stay (OR 2.11; 95%-CI 1.04; 4.29) perceived significantly more social support from nurses.; (4) Conclusions: Designing a supportive nursing work environment and improving process organization in hospitals may create conditions conducive for a supportive patient-nurse interaction. More research is needed to better understand mechanisms behind the associations found.
(1) 背景:有证据表明,医院的组织流程对医患互动有影响。在护患互动中,护士在提供社会支持方面发挥着关键作用。影响护患互动的因素很少被研究过。我们旨在研究医院的流程组织是否与乳腺癌患者感知到的来自护士的社会支持有关。
(2) 方法:基于横断面患者调查(2979 名乳腺癌患者,83 家德国医院)和医院结构信息进行数据分析。使用逻辑层次回归模型,调整患者特征和医院结构后,分析流程组织与感知社会支持之间的关联。
(3) 结果:大多数患者年龄在 40-69 岁,UICC 分期为 II 期或 III 期。母语、年龄和医院所有权状况与社会支持的感知显著相关。在入院时(优势比 3.61;95%置信区间 1.67,7.78)和住院期间(优势比 2.11;95%置信区间 1.04;4.29)流程组织较好的医院接受治疗的患者,感知到来自护士的社会支持明显更多。
(4) 结论:设计支持性护理工作环境和改善医院流程组织可以为支持性的医患互动创造条件。需要进一步研究以更好地理解发现的关联背后的机制。