Cumming School of Medicine, University of Calgary; Health Sciences Centre, Foothills campus, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada.
Alberta Children's Hospital Research Institute, University of Calgary, Room 293, Heritage Medical Research Building, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.
Injury. 2023 Jul;54(7):110729. doi: 10.1016/j.injury.2023.04.016. Epub 2023 Apr 22.
Injured adolescents may be treated at pediatric trauma centres (PTCs) or adult trauma centres (ATCs). Patient and parent experiences are an integral component of high-quality health care and can influence patient clinical trajectory. Despite this knowledge, there is little research on differences between PTCs and ATCs with respect to patient and caregiver-reported experience. We sought to identify differences in patient and parent-reported experiences between the regional PTC and ATC using a recently developed Patient and Parent-Reported Experience Measure.
We prospectively enrolled patients (caregivers) aged 15-17 (inclusive), admitted to the local PTC and ATC for injury management (01/01/2020 - 31/05/2021) We provided a survey 8-weeks post-discharge to query acute care and follow-up experience. Patient and parent experiences were compared between the PTC and ATC using descriptive statistics, chi-square tests for categorical and independent t-tests for continuous variables.
We identified 90 patients for inclusion (51 PTC, and 39 ATC). From this population, we had 77 surveys (32 patient and 35 caregiver) completed at the PTC, and 41 (20 patient and 21 caregiver) at the ATC. ATC patients tended to be more severely injured. We identified few differences in reported experience on the patient measure but identified lower ratings from caregivers of adolescents treated in ATCs for the domains of information and communication, follow-up care, and overall hospital scores. Patients and parents reported poorer family accommodation at the ATC.
Patient experiences were similar between centres. However, caregivers report poorer experiences at the ATC in several domains. These differences are multifaceted, and may reflect differing patient volumes, effects of COVID-19, and healthcare paradigms. However, further work should target information and communication improvement in adult paradigms given its impact on other domains of care.
受伤的青少年可能在儿科创伤中心（PTC）或成人创伤中心（ATC）接受治疗。患者和家长的体验是高质量医疗保健的一个组成部分，会影响患者的临床轨迹。尽管有此认识，但关于 PTC 和 ATC 之间在患者和护理人员报告的体验方面的差异，研究甚少。我们试图使用最近开发的患者和家长报告的体验量表，确定区域 PTC 和 ATC 之间在患者和家长报告的体验方面的差异。
我们前瞻性地招募了年龄在 15-17 岁（含）之间，因受伤管理而入住当地 PTC 和 ATC 的患者（护理人员）（2020 年 1 月 1 日至 2021 年 5 月 31 日）。我们在出院后 8 周提供了一项调查，以查询急性护理和随访体验。使用描述性统计、分类的卡方检验和连续变量的独立 t 检验，比较 PTC 和 ATC 之间的患者和家长体验。
我们确定了 90 名符合条件的患者（51 名 PTC 和 39 名 ATC）。在这一人群中，我们在 PTC 完成了 77 份调查（32 份患者和 35 份护理人员），在 ATC 完成了 41 份调查（20 份患者和 21 份护理人员）。ATC 患者的伤势往往更严重。我们在患者量表上报告的体验差异很少，但在 ATC 接受治疗的青少年的信息和沟通、随访护理和整体医院评分等领域，护理人员的评分较低。患者和家长报告 ATC 的家庭住宿条件较差。
患者体验在各中心相似。然而，在几个领域，护理人员在 ATC 的体验较差。这些差异是多方面的，可能反映了不同的患者量、COVID-19 的影响和医疗保健模式。然而，鉴于其对其他护理领域的影响，应进一步努力改善成人模式中的信息和沟通。
