Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
J Gen Intern Med. 2023 Sep;38(12):2703-2709. doi: 10.1007/s11606-023-08178-4. Epub 2023 Mar 27.
Patient understanding of their care, supported by physician involvement and consistent communication, is key to positive health outcomes. However, patient and care team characteristics can hinder this understanding.
We aimed to assess inpatients' understanding of their care and their perceived receipt of mixed messages, as well as the associated patient, care team, and hospitalization characteristics.
We administered a 30-item survey to inpatients between February 2020 and November 2021 and incorporated other hospitalization data from patients' health records.
Randomly selected inpatients at two urban academic hospitals in the USA who were (1) admitted to general medicine services and (2) on or past the third day of their hospitalization.
Outcome measures include (1) knowledge of main doctor and (2) frequency of mixed messages. Potential predictors included mean notes per day, number of consultants involved in the patient's care, number of unit transfers, number of attending physicians, length of stay, age, sex, insurance type, and primary race.
A total of 172 patients participated in our survey. Most patients were unaware of their main doctor, an issue related to more daily interactions with care team members. Twenty-three percent of patients reported receiving mixed messages at least sometimes, most often between doctors on the primary team and consulting doctors. However, the likelihood of receiving mixed messages decreased with more daily interactions with care team members.
Patients were often unaware of their main doctor, and almost a quarter perceived receiving mixed messages about their care. Future research should examine patients' understanding of different aspects of their care, and the nature of interactions that might improve clarity around who's in charge while simultaneously reducing the receipt of mixed messages.
患者对自身护理的理解，辅以医生的参与和持续的沟通，是取得积极健康结果的关键。然而，患者和护理团队的特征可能会阻碍这种理解。
我们旨在评估住院患者对自身护理的理解程度和他们对混合信息的感知程度，以及相关的患者、护理团队和住院特征。
我们在 2020 年 2 月至 2021 年 11 月期间向美国两家城市学术医院的住院患者发放了一份包含 30 个项目的调查问卷，并结合了患者健康记录中的其他住院数据。
随机选择在美国两家城市学术医院接受普通内科服务且（1）住院时间在 3 天或以上的住院患者。
结局指标包括（1）对主治医生的了解程度和（2）混合信息的频率。潜在预测因素包括平均每日记录数量、参与患者护理的顾问数量、单位转移次数、主治医生数量、住院时间、年龄、性别、保险类型和主要种族。
共有 172 名患者参与了我们的调查。大多数患者不知道他们的主治医生，这与他们与护理团队成员的日常互动更多有关。23%的患者报告至少有时收到混合信息，最常见于主治医生和顾问医生之间。然而，随着与护理团队成员的日常互动增加，收到混合信息的可能性降低。
患者经常不知道他们的主治医生，几乎有四分之一的患者认为他们收到了关于护理的混合信息。未来的研究应该检查患者对自身护理不同方面的理解程度，以及可能提高谁负责的清晰度并同时减少混合信息接收的互动性质。
