Health Sciences Program, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, SK, S7N OW8, Saskatoon, Canada.
BMC Nephrol. 2021 Sep 23;22(1):318. doi: 10.1186/s12882-021-02499-4.
People living with chronic kidney disease (CKD) require complex medical management and may be frequently hospitalized. Patient safety incidents during hospitalization can result in serious complications which may negatively affect health outcomes. There has been limited examination of how these patients perceive their own safety.
This study compared the safety perceptions of patients hospitalized with CKD using two approaches: (a) the Patient Measure of Safety (PMOS) questionnaire and (b) qualitative interviews. The study objectives were to: (1) assess concordance between qualitative and quantitative data on safety perceptions and (2) better understand safety as perceived by study participants.
A cross-sectional convergent mixed methods design was used. Integration at the reporting level occurred by weaving together patient narratives and survey domains through the use of a joint display. Interview data were merged with results of the PMOS on a case-by-case basis for analysis to assess for concordance or discordance between these approaches to safety data collection.
Of the 30 inpatients with CKD, almost one quarter (23.3 %) of participants reported low levels of perceived safety in hospitals. Four major themes emerged from the interviews: receiving safe care; expecting to be taken care of; expecting to be cared for; and reporting safety concerns. Suboptimal communication, delays in care and concerns about technical aspects of care were common to both forms of data collection. Concordance was noted between qualitative and quantitative data with respect to communication/teamwork, respect and dignity, staff roles, and ward type/lay-out. While interviews allowed for participants to share specific concerns related to safety about quality of interpersonal interactions, use of the questionnaire alone did not capture this concern.
Safety issues are a concern for in-patients with CKD. Both quantitative and qualitative approaches provided important and complementary insights into these issues. Narratives were mostly concordant with questionnaire scores. Findings from this mixed methods study suggest that communication, interpersonal interactions, and delays in care were more concerning for participants than technical aspects of care. Eliciting the concerns of people with CKD in a systematic fashion, either through interviews or a survey, ensures that hospital safety improvement efforts focus on issues important to patients.
患有慢性肾病（CKD）的患者需要复杂的医疗管理，并且可能经常住院。住院期间的患者安全事件可能导致严重的并发症，从而对健康结果产生负面影响。目前，对这些患者如何感知自身安全的研究有限。
本研究使用两种方法比较了患有 CKD 的住院患者的安全感知：（a）患者安全测量（PMOS）问卷和（b）定性访谈。研究目的是：（1）评估定性和定量数据在安全感知方面的一致性，以及（2）更好地理解研究参与者感知到的安全。
采用横断面收敛混合方法设计。通过使用联合展示，将患者的叙述和调查领域编织在一起，在报告层面进行整合。访谈数据与 PMOS 的结果逐个案例合并进行分析，以评估这些安全数据收集方法之间的一致性或不一致性。
在 30 名患有 CKD 的住院患者中，近四分之一（23.3%）的参与者报告在医院的安全水平较低。访谈中出现了四个主要主题：接受安全护理；期望得到照顾；期望得到照顾；以及报告安全问题。沟通不畅、护理延误和对护理技术方面的担忧在两种数据收集方式中都很常见。定性和定量数据在沟通/团队合作、尊重和尊严、员工角色以及病房类型/布局方面具有一致性。虽然访谈允许参与者分享与安全相关的具体问题，这些问题与人际互动的质量有关，但仅使用问卷无法捕捉到这一问题。
安全问题是 CKD 住院患者关注的问题。定量和定性方法都为这些问题提供了重要且互补的见解。叙述与问卷评分大多一致。这项混合方法研究的结果表明，与护理技术方面相比，沟通、人际互动和护理延误更让参与者感到担忧。以系统的方式了解 CKD 患者的关注点，无论是通过访谈还是调查，都可以确保医院安全改进工作集中在患者关心的问题上。
