Institute of Health and Wellbeing, Federation University Australia, Churchill, Victoria, Australia.
School of Nursing and Midwifery, La Trobe University, Bundoora, Australia.
J Adv Nurs. 2022 Dec;78(12):4062-4070. doi: 10.1111/jan.15336. Epub 2022 Jul 13.
This paper explores the personal, social and structural factors that influence patients' experiences of acute deterioration and medical emergency team (MET) encounter.
Patient experience is recognized as a means of assessing healthcare delivery with a positive experience being linked to high-quality healthcare, improved patient safety and reduced length of stay. The experience of acute deterioration is unique, extensive and complex. However, little is known about this experience from the patient's perspective.
Constructivist grounded theory, informed by Kathy Charmaz, was used to explore the personal, social and structural factors that influence patients' experiences of acute deterioration and MET encounter.
Using a semi-structured interview guide, in-depth individual interviews were conducted with 27 patients from three healthcare services in Victoria, Australia. Data were collected over a 12-month period from 2018 to 2019. Interview data were analysed using grounded theory processes.
Contextual factors exert a powerful influence on patients' experiences of acute deterioration and MET encounter. The most significant factors identified include patients' expectations and illness perception, relationship with healthcare professionals during MET call and past experiences of acute illness. The expectations and perceptions patients had about their disease can condition their overall experience. Healthcare professional-patient interactions can significantly impact quality of care, patient experience and recovery. Patients' experiences of illness and healthcare can impact a person's future health-seeking behaviour and health status.
Patients' actions and processes about their experiences of acute deterioration and MET encounter are the result of the complex interface of contextual factors.
The findings from this study have highlighted the need for revised protocols for screening and management of patients who experience acute deterioration.
本文探讨了影响患者急性恶化和医疗应急团队（MET）遭遇体验的个人、社会和结构因素。
患者体验被认为是评估医疗保健服务的一种手段，积极的体验与高质量的医疗保健、提高患者安全性和缩短住院时间有关。急性恶化的体验是独特的、广泛的和复杂的。然而，从患者的角度来看，人们对这种体验知之甚少。
受 Kathy Charmaz 的启发，采用建构主义扎根理论来探讨影响患者急性恶化和 MET 遭遇体验的个人、社会和结构因素。
使用半结构化访谈指南，对来自澳大利亚维多利亚州的三家医疗服务机构的 27 名患者进行了深入的个人访谈。访谈数据于 2018 年至 2019 年期间收集了 12 个月。使用扎根理论过程对访谈数据进行了分析。
背景因素对患者的急性恶化和 MET 遭遇体验产生了强大的影响。确定的最重要因素包括患者的期望和疾病认知、MET 呼叫期间与医疗保健专业人员的关系以及过去急性疾病的经历。患者对疾病的期望和认知可以影响他们的整体体验。医护人员与患者的互动可以显著影响护理质量、患者体验和康复。患者的疾病体验和医疗经历会影响他们未来的寻医行为和健康状况。
患者对急性恶化和 MET 遭遇体验的行为和过程是复杂的背景因素相互作用的结果。
本研究的结果强调了需要修订用于筛查和管理经历急性恶化的患者的协议。
