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患者对基层医疗医生的信任:沙特阿拉伯东部省份大学附属医院糖尿病患者的混合方法研究

Patient Trust in Primary Care Physicians: A Mixed Methods Study of Persons with Diabetes at University- Based Clinics in the Eastern Province of Saudi Arabia.

作者信息

Boubshait Leila A, AlShamlan Nouf A, AlShammari Razan Z, Alamrah Shadin A, Fallatah Bashaer A, Abdel Wahab Moataza M, Alreedy Abdullah H

机构信息

Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.

出版信息

Patient Prefer Adherence. 2022 Dec 13;16:3241-3255. doi: 10.2147/PPA.S377500. eCollection 2022.

Abstract

BACKGROUND

The establishment of patient trust in physicians is becoming increasingly valuable. Trust can be fundamental to successful patient care, favorable patient outcomes and improved financial savings for healthcare organizations. This study aims to explore patients' perceptions of trust in physicians, determine factors that play a role in this relationship, and to identify ways to improve patient trust.

METHODS

The study was conducted via a mixed-method design using semi-structured in-depth interviews until data saturation was reached (n=24), followed by a cross sectional survey of consecutive sampling until the number of participants (n=256) exceeded the required sample size. Adult patients with diabetes, aged 18-65, attending internal medicine (IM) or family medicine (FM) clinics of King Fahd Hospital of the University, Saudi Arabia were included in the interviews and surveys. Patients' interview transcripts were analyzed into trust dimensions resulting in a 51-item scale. Quality function deployment (QFD) was used to define the highest priority patient requirements. Overall satisfaction was calculated as a satisfaction percent, and factors related to satisfaction were tested using independent samples -test and ANOVA.

RESULTS

Significant domains for establishing patient trust in physicians were the perceived physician's competency level, comprehensiveness of care, morals, personal traits, and establishing continuity of care. The trust score ranged from 42.0% to 100% with an average of 90.4%. There was no difference between the FM and IM setting, nor between the sociodemographic factors and the patients' satisfaction level. No statistically significant results were found between diabetes type, years of diagnoses, achieving the target HbA1c with patients' satisfaction level and trust. Patients reporting hypo or hyperglycemic symptoms had lower levels of satisfaction than those who did not.

CONCLUSION

Persons with diabetes were more trustful of primary care physicians if they displayed satisfactory communication skills, experience, and a caring attitude.

摘要

背景

患者对医生信任的建立正变得越来越有价值。信任对于成功的患者护理、良好的患者治疗结果以及医疗保健机构节省更多资金可能至关重要。本研究旨在探讨患者对医生信任的看法,确定在这种关系中起作用的因素,并找出提高患者信任的方法。

方法

本研究采用混合方法设计,先进行半结构化深度访谈直至达到数据饱和(n = 24),随后对连续抽样进行横断面调查,直至参与者数量(n = 256)超过所需样本量。年龄在18 - 65岁、在沙特阿拉伯法赫德国王大学医院内科(IM)或家庭医学(FM)诊所就诊的成年糖尿病患者被纳入访谈和调查。患者的访谈记录被分析为信任维度,形成一个51项的量表。质量功能展开(QFD)用于确定患者的最高优先需求。总体满意度以满意度百分比计算,与满意度相关的因素使用独立样本t检验和方差分析进行检验。

结果

建立患者对医生信任的重要领域包括感知到的医生能力水平、护理的全面性、道德、个人特质以及建立护理连续性。信任得分范围为42.0%至100%,平均为90.4%。FM和IM环境之间、社会人口统计学因素与患者满意度水平之间均无差异。在糖尿病类型、诊断年限、达到目标糖化血红蛋白水平与患者满意度和信任之间未发现统计学上的显著结果。报告有低血糖或高血糖症状的患者满意度低于没有这些症状的患者。

结论

糖尿病患者如果对初级保健医生的沟通技巧、经验和关怀态度感到满意,就会对他们更信任。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b1/9759089/39f5e0502a3d/PPA-16-3241-g0001.jpg

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