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COVID-19 住院患者出院后的护理评估:满意度和未满足的需求。

Patients' evaluation of aftercare following hospitalization for COVID-19: satisfaction and unmet needs.

机构信息

Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.

Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

Respir Res. 2024 Mar 29;25(1):145. doi: 10.1186/s12931-024-02748-8.

Abstract

BACKGROUND

Patient experiences with COVID-19 aftercare remain largely unknown. We evaluated COVID-19 aftercare from a patient perspective one year after hospitalization, assessing satisfaction and its associated factors, and unmet needs.

METHODS

The Satisfaction with COVID-19 Aftercare Questionnaire (SCAQ) was developed as part of a multicenter prospective cohort study and administered one year after hospital discharge. The SCAQ assesses (1) patient satisfaction, comprising information provision, rehabilitation, follow-up by hospitals and general practitioners (GPs), the most important aftercare topics, and overall satisfaction, and (2) unmet needs.

RESULTS

487/561 (87%) COVID-19 patients completed the SCAQ, all had been discharged from the hospital between March 2020 and May 2021. Among responders, the median age of patients was 60 (IQR 54-67) years, 338 (69%) were male, and the median length of stay in the hospital was 13 (6-27) days. Patients were least satisfied with information on who could be contacted with questions when health problems arise (59% satisfied or very satisfied). Many patients (75%) received rehabilitation, most frequently community-based (70%). Across the different community-based therapies, ≥ 60% of patients were satisfied with shared-decision making and ≥ 70% with the received therapy; a majority (≥ 79%) indicated a preference for receiving the same therapy again if needed. Regarding follow-up by hospitals, 86% of patients received this follow-up, most frequently visiting a pulmonologist (96%), being generally satisfied with the received aftercare. Aftercare from GPs was received by 39% of patients, with 88% being satisfied with the GP's availability and 79% with referral to appropriate aftercare providers. Patients (> 50%) considered information-related items most important in aftercare. Overall, patients rated their satisfaction with aftercare 8/10 (7-9) points. Those who received medical rehabilitation (versus no rehabilitation, adjusted beta 0.61 [95%CI 0.11 to 1.11], p = 0.02) or aftercare by a hospital medical specialist (1.1 [0.46 to 1.64], p < 0.001) or GP (0.39 [0.053 to 0.72], p = 0.023) reported significantly higher satisfaction than those without such aftercare. Unmet needs were reported by 35% of patients, with lack of information (20%) and lack of additional aftercare and/or involvement of their GP (19%) being the most frequently reported.

CONCLUSION

Despite the forced quick development of COVID-19 aftercare, patients were generally satisfied. Follow-up by healthcare professionals and information provision is important to meet patients' aftercare needs.

摘要

背景

COVID-19 患者的康复后体验在很大程度上仍不为人知。我们从患者的角度评估了 COVID-19 患者在住院一年后的康复后情况,评估了满意度及其相关因素和未满足的需求。

方法

作为一项多中心前瞻性队列研究的一部分,开发了 COVID-19 康复后满意度问卷(SCAQ),并在出院一年后进行了评估。SCAQ 评估了(1)患者满意度,包括信息提供、康复、医院和全科医生(GP)的随访、最重要的康复后主题以及总体满意度,以及(2)未满足的需求。

结果

在 561 名 COVID-19 患者中,有 487 名(87%)完成了 SCAQ,所有患者均于 2020 年 3 月至 2021 年 5 月期间从医院出院。在应答者中,患者的中位年龄为 60(IQR 54-67)岁,338 名(69%)为男性,中位住院时间为 13(6-27)天。患者对健康问题出现时可联系到的人员的信息最不满意(59%的人表示满意或非常满意)。许多患者(75%)接受了康复治疗,最常见的是社区康复治疗(70%)。在不同的社区康复治疗中,≥60%的患者对共同决策感到满意,≥70%的患者对接受的治疗感到满意;大多数(≥79%)患者表示,如果需要,他们更愿意再次接受相同的治疗。关于医院随访,86%的患者接受了随访,最常见的是看肺病专家(96%),对接受的康复后护理总体满意。39%的患者接受了全科医生的康复后护理,88%的患者对全科医生的可用性感到满意,79%的患者对转诊给适当的康复后护理提供者感到满意。患者(>50%)认为信息相关项目是康复后护理中最重要的。总体而言,患者对康复后护理的满意度评分为 8/10(7-9)分。接受医疗康复(与未接受康复相比,调整后的β值为 0.61[95%CI 0.11 至 1.11],p=0.02)或由医院专科医生(1.1[0.46 至 1.64],p<0.001)或全科医生(0.39[0.053 至 0.72],p=0.023)提供的康复后护理的患者报告的满意度明显高于未接受此类康复后护理的患者。35%的患者报告存在未满足的需求,最常见的是缺乏信息(20%)和缺乏额外的康复后护理和/或 GP 的参与(19%)。

结论

尽管 COVID-19 康复后护理的快速发展是强制性的,但患者总体上还是满意的。医疗保健专业人员的随访和信息提供对于满足患者的康复后需求很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43cf/10981299/5e262979f2ef/12931_2024_2748_Fig1_HTML.jpg

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