Department of Family Medicine (Syed), Queen's University, Kingston, Ont.; School of Physical and Occupational Therapy (Stilwell), McGill University, Montréal, Que.; Michael Garron Hospital (Chevrier, Adair), Toronto, Ont.; Crafts (Textiles) (Markle), Nova Scotia College of Art and Design University; Division of Geriatric Medicine (Rockwood), Department of Medicine, Dalhousie University, Halifax, NS
Department of Family Medicine (Syed), Queen's University, Kingston, Ont.; School of Physical and Occupational Therapy (Stilwell), McGill University, Montréal, Que.; Michael Garron Hospital (Chevrier, Adair), Toronto, Ont.; Crafts (Textiles) (Markle), Nova Scotia College of Art and Design University; Division of Geriatric Medicine (Rockwood), Department of Medicine, Dalhousie University, Halifax, NS.
CMAJ Open. 2022 Dec 20;10(4):E1079-E1087. doi: 10.9778/cmajo.20210271. Print 2022 Oct-Dec.
The standard hospital gown has remained relatively unchanged despite reports that it is uncomfortable, embarrassing to wear and compromises patients' dignity. The objective of this qualitative study was to explore the experiences and perspectives of stakeholders involved in the gown life cycle.
We conducted a constructivist, qualitative interview study with a patient-oriented lens. A patient partner was fully integrated into our research team and directly involved in interview guide development, recruitment, data collection, analysis and writing. We audio-recorded telephone interviews with adult (i.e., aged 18 yr or older) patients and family members, interdisciplinary clinicians and key system stakeholders (e.g., designers, manufacturers, textile experts) in North America. We used a hybrid deductive-inductive approach to coding and theme development. This study took place from May 2018 to March 2020.
Analysis of 40 stakeholder interviews (8 patients and family members, 12 clinicians, 20 system stakeholders) generated 4 themes: utility, economics, comfort and dignity, and aesthetics. Patients and clinicians emphasized that current gowns have many functional limitations. By contrast, system stakeholders emphasized that gowns need to be cost-effective and aligned with established health care processes and procedures. Across the stakeholder groups, hospital gowns were reported to not fulfill patients' needs and to negatively affect patients' and families' health care experiences.
Our findings suggest that the standard hospital gown fails to meet the needs of those involved in providing and receiving high-quality health care. Redesigning the gown would be a step toward increased person-centred care and requires partnership across the stakeholder groups involved in the gown life cycle to minimize implementation barriers while placing patients' needs at the forefront.
尽管有报道称医院的标准病号服穿着不舒服、令人尴尬且有损患者尊严,但它的设计却基本保持不变。本研究旨在从利益相关者的角度探索病号服全生命周期的体验和看法。
我们开展了一项以患者为中心的建构主义定性访谈研究。我们的研究团队充分融入了一名患者伙伴,该伙伴直接参与访谈指南的制定、患者和家属的招募、数据收集、分析和报告的撰写。我们通过电话采访了北美地区的成年患者(18 岁及以上)及其家属、跨学科临床医生和关键系统利益相关者(如设计师、制造商、纺织专家)。我们采用了一种演绎-归纳相结合的混合编码和主题开发方法。本研究于 2018 年 5 月至 2020 年 3 月进行。
对 40 名利益相关者访谈(8 名患者和家属、12 名临床医生、20 名系统利益相关者)的分析产生了 4 个主题:实用性、经济性、舒适性和尊严感、美观性。患者和临床医生强调目前的病号服有许多功能上的局限性。相比之下,系统利益相关者则强调病号服需要具有成本效益,并且与既定的医疗保健流程和程序保持一致。在所有利益相关者群体中,病号服被认为无法满足相关人员的需求,并对患者及其家属的医疗体验产生负面影响。
我们的研究结果表明,标准病号服无法满足提供和接受高质量医疗保健服务的人群的需求。重新设计病号服将是迈向以人为本的护理的一步,需要参与病号服全生命周期的利益相关者合作,以最小化实施障碍,同时将患者的需求放在首位。