Kerluku Jona, Wessel Lauren E, Bido Jennifer, Verret Claire Isabelle, Fufa Duretti
Department of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, NY.
Department of Orthopaedic Surgery, University of California, Los Angeles, CA.
J Hand Surg Glob Online. 2024 May 9;6(4):529-533. doi: 10.1016/j.jhsg.2024.04.002. eCollection 2024 Jul.
Effective patient-doctor communication is linked to improved patient functional and physiological health status, better adherence to physician recommendations, and increased patient satisfaction. However, studies show that patients have difficulty understanding and recalling information discussed during a medical encounter. The purpose of this study was to assess patient engagement, patient-doctor communication, and patient-doctor interactions with the utilization of a patient encounter card to help aid in communication.
New patients presenting to a single hand surgeon during an 8-month period between 2019 and 2020 were recruited for this study. Patients were recruited in pre and postintervention phases, defined by the rollout of a patient encounter card. Patients studied in the preintervention group were defined as the control population and experienced a typical office visit. The postintervention group experienced a typical office visit with the addition of a patient encounter card distributed to patients prior to meeting with the physician and screened by the physician during the visit to guide the encounter. Patient satisfaction and engagement surveys were collected during patient checkout process.
Two hundred eighty-seven patients (70% participation rate) were enrolled in the preintervention (145) and postintervention (142) phases. The utilization of a patient encounter card for setting a visit agenda resulted in a significant increase in self-reported patient engagement, improving from 74% to 88%. In both phases, 98% of patients felt that the physician listened well or very well and reported high levels of confidence in the provider being able to address their primary health concerns (72% and 79%, respectively). Overall, patient satisfaction was maintained pre and postintervention (96% and 98%, respectively).
Use of the encounter card improved patients' feelings of engagement during their visits. Further research is required to determine the impact of these tools on providers' engagement and patient outcomes to improve quality of care in hand surgery.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.
有效的医患沟通与患者功能和生理健康状况的改善、对医生建议更好的依从性以及患者满意度的提高相关。然而，研究表明患者在理解和回忆医疗过程中讨论的信息方面存在困难。本研究的目的是评估患者参与度、医患沟通以及医患互动，并利用患者诊疗卡来辅助沟通。
招募2019年至2020年期间在8个月内就诊于一位手外科医生的新患者参与本研究。患者在干预前和干预后阶段被招募，干预阶段由患者诊疗卡的推出界定。干预前组的患者被定义为对照人群，经历典型的门诊就诊。干预后组经历典型的门诊就诊，在此基础上增加在与医生会面之前分发给患者并在就诊期间由医生筛查以指导诊疗的患者诊疗卡。在患者结账过程中收集患者满意度和参与度调查。
287名患者（参与率70%）被纳入干预前（145名）和干预后（142名）阶段。使用患者诊疗卡来设定就诊议程导致自我报告的患者参与度显著提高，从74%提高到88%。在两个阶段中，98%的患者认为医生倾听良好或非常良好，并报告对医生能够解决其主要健康问题有很高的信心（分别为72%和79%）。总体而言，干预前和干预后患者满意度均保持在较高水平（分别为96%和98%）。
诊疗卡的使用改善了患者就诊期间的参与感。需要进一步研究以确定这些工具对医生参与度和患者结局的影响，从而提高手外科护理质量。
研究类型/证据水平：治疗性II级。
