Clinical Research Centre, Copenhagen University Hospital, Amager Hvidovre, Copenhagen, Denmark.
Department of Emergency Medicine, Copenhagen University Hospital, Amager Hvidovre, Copenhagen, Denmark.
Scand J Caring Sci. 2023 Sep;37(3):654-661. doi: 10.1111/scs.13147. Epub 2023 Jan 30.
To assess the agreement between patients' self-reported degree-of-worry (DOW) and nurses' evaluation of patients' DOW.
An observational cohort study with patients and their primary nurses.
Between 22 February and 27 March 2021, data collection among patients and their nurses in an emergency department was carried out. Patients ≥18 years, cognitively intact and Danish or English speaking were eligible to participate. Nurses regardless of seniority and gender were eligible for participation. The single-item degree-of-worry measure, 'how worried are you about the condition you are here today on a scale from 1 to 10, where 1 is minimally worried and 10 is maximum worried' as well as information on gender, age, co-morbidity, triage level and medical reason for encounter was collected from patients. The corresponding nurses were asked; 'how worried do you think your patient is about the condition he/she is there today on a scale from 1 to 10, where 1 is minimally worried and 10 is maximum worried?' Nurses also supplied data on gender, age, seniority as a Registered Nurse and in the ED. Agreement between patients' self-reported degree-of-worry and nurses' evaluation of patients' degree-of-worry was assessed with weighted Cohen's Kappa.
A total of 194 patient-nurse pairs were included for analysis. The agreement between patients' DOW and nurses' evaluation of patients' DOW categorised as DOW , DOW and DOW was in total agreement in n = 85 pairs (43.8%) of the ratings, which corresponds to a weighted Cohen's Kappa of 0.19 (0.08-0.30; p < 0.001).
Nurses estimate of their patients' DOW was in very poor agreement. This indicates that nurses are not able to assess the patient's DOW to a satisfactory level. This result is troubling as it may have serious consequences for patient care as it indicates that the nurses do not know their patients' perspectives.
评估患者自我报告的担忧程度（DOW）与护士对患者 DOW 的评估之间的一致性。
一项对患者及其主管护士进行的观察性队列研究。
2021 年 2 月 22 日至 3 月 27 日期间，在急诊科对患者及其护士进行了数据收集。年龄≥18 岁、认知正常、会说丹麦语或英语的患者符合纳入标准。不论资历和性别，护士均符合参与条件。从患者处收集了单一的担忧程度测量项目“您对今天在这里的病情有多担心，范围从 1 到 10，其中 1 表示最小程度的担心，10 表示最大程度的担心”以及性别、年龄、合并症、分诊级别和就诊原因等信息。主管护士则被要求回答：“您认为您的患者对他/她今天的病情有多担心，范围从 1 到 10，其中 1 表示最小程度的担心，10 表示最大程度的担心？”护士还提供了性别、年龄、作为注册护士的资历以及在急诊科的资历等数据。使用加权 Cohen's Kappa 评估患者自我报告的担忧程度与护士对患者担忧程度的评估之间的一致性。
共纳入了 194 对患者-护士进行了分析。患者 DOW 和护士对患者 DOW 的评估分类为 DOW 、 DOW 和 DOW ，在 n=85 对评分中完全一致（占总评分的 43.8%），加权 Cohen's Kappa 为 0.19（0.08-0.30；p<0.001）。
护士对患者 DOW 的评估与非常不一致。这表明护士无法对患者的 DOW 进行令人满意的评估。这个结果令人不安，因为它可能对患者护理产生严重后果，表明护士不知道患者的观点。
