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从识别患者安全风险到报告患者投诉:一项关于患者医院体验的扎根理论研究。

From identifying patient safety risks to reporting patient complaints: A grounded theory study on patients' hospital experiences.

机构信息

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Medicine, Geriatrics, and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

J Clin Nurs. 2024 Nov;33(11):4421-4433. doi: 10.1111/jocn.17355. Epub 2024 Jul 1.

Abstract

AIM

To explore how patients with hospital experience construct patient safety, from the identification of a patient safety risk to the decision to file a complaint.

BACKGROUND

Patients play an important role in the prevention of adverse events in hospitals, but the ability of patients to act and influence their own safety is still challenged by multiple factors. Understanding how patients perceive risk and act to prevent harm may shed light on how to enhance patients' opportunities to participate in patient safety.

DESIGN

The research design of this study is qualitative and exploratory.

METHODS

Twelve participants who had experienced Swedish hospital care were interviewed between June 2022 and July 2023. The method of analysis was constructivist grounded theory, focusing on social processes. The COREQ checklist for qualitative research was followed.

RESULTS

Four categories were constructed: (1) defining the boundary between one's own capacity and that of the hospital, (2) acting to minimize the impact on one's safety, (3) finding oneself in the hands of healthcare professionals and (4) exploring the boundaries between normality and abnormality of the situation. This process was captured in the core category of navigating the path of least suffering. This illustrated how the participants constructed meaning about patient safety risks and showed that they prevented multiple adverse events.

CONCLUSIONS

Provided that participants were able to act independently, they avoided a multitude of adverse events. When they were dependent on healthcare professionals, their safety became more vulnerable. Failure to respond to the participants' concerns could lead to long-term suffering.

RELEVANCE TO CLINICAL PRACTICE

By responding immediately to patients' concerns about their safety, healthcare professionals can help prevent avoidable suffering and exhaustive searching for someone in the healthcare system who will take their needs seriously.

PATIENT CONTRIBUTION

A member check was performed with the help of one of the participants who read the findings to confirm familiarity.

摘要

目的

从识别患者安全风险到决定提出投诉,探讨患者对医院体验中患者安全的构建。

背景

患者在预防医院不良事件中发挥着重要作用,但患者采取行动和影响自身安全的能力仍受到多种因素的挑战。了解患者如何感知风险并采取行动防止伤害,可能有助于增强患者参与患者安全的机会。

设计

本研究的研究设计为定性和探索性。

方法

2022 年 6 月至 2023 年 7 月期间,对 12 名经历过瑞典医院护理的参与者进行了访谈。分析方法是建构主义扎根理论,重点关注社会过程。遵循了定性研究的 COREQ 清单。

结果

构建了四个类别:(1)定义自身能力和医院能力的边界,(2)采取行动将对自身安全的影响降到最低,(3)将自己置于医疗保健专业人员的手中,(4)探索情况的正常和异常之间的边界。这一过程在核心类别“规避痛苦最小化路径”中得以体现。这说明了参与者如何构建患者安全风险的意义,并表明他们预防了多次不良事件。

结论

只要参与者能够独立行动,他们就可以避免许多不良事件。当他们依赖医疗保健专业人员时,他们的安全就变得更加脆弱。未能回应参与者对安全的担忧可能会导致长期的痛苦。

临床实践的相关性

通过立即回应患者对自身安全的关注,医疗保健专业人员可以帮助预防可避免的痛苦,并避免在医疗保健系统中寻找认真对待他们需求的人。

患者贡献

在其中一名参与者的帮助下进行了一次成员检查,让他阅读研究结果以确认熟悉程度。

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