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报告择期围手术期护理中的患者体验:范围综述。

Reporting patient experiences within elective perioperative care: a scoping review.

机构信息

Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, Queensland 4226, Australia.

Bond Business School, Bond University.

出版信息

Int J Qual Health Care. 2024 Sep 14;36(3). doi: 10.1093/intqhc/mzae085.

Abstract

Patient experience is an important descriptor of the human experience of healthcare. Specifically, it is described as the sum of all interactions, shaped by an organization's culture, that influence patient perceptions, across the continuum of care. Currently, patient experience is measured with a focus on the hospital experience. By focussing on elective perioperative care, patient experience across the full continuum of care can be explored. A scoping review was designed to map the important components of patient experience, reported from previous studies of patients' perspectives, across the full continuum of care. The aims of this scoping review were to identify (i) key components of patients' experience and (ii) strategies where clinicians have influenced this experience. A systematic search of four key databases was performed in 2022 and updated in 2023 to identify primary research articles describing the complete perioperative experience for adults who have had elective surgery. Patient reports were extracted and compared to summarize key components of patient experience across preoperative, in-hospital, and postoperative care and to identify components of patient experience that clinicians could influence. From 10 included studies, four important patient experience themes have emerged as realistic expectations, accurate information, consistent communication, and individualized care. Four foci for clinicians to influence patients' experience include careful monitoring around pain management, psychological recovery, coordination of care, and return to function. A matrix of clinicians' points of influence and patient experience is presented to demonstrate how clinicians have influenced important components of patient experience across preoperative, in-hospital, and postoperative care. This review summarizes patients' reports of their experience across the complete perioperative continuum of care. The multidimensional nature of the patient experience is represented in four patient experience themes. Four focus areas in which clinicians can influence patients' experiences across the continuum of care are key to understanding and respecting the human experience in healthcare. This dynamic description of patient experience may focus clinicians' understanding of this complex construct and assist their practical engagement with patients. Further work is needed to ensure these themes are sufficiently relevant and comprehensive for current and future patients. Practical strategies will be important for clinicians to individualize and deliver perioperative care that respects and enhances their patients' experiences.

摘要

患者体验是医疗保健中人类体验的一个重要描述符。具体来说,它被描述为组织文化影响患者感知的所有交互作用的总和,贯穿整个护理过程。目前,患者体验是通过关注医院体验来衡量的。通过关注择期围手术期护理,可以探索整个护理过程中的患者体验。本研究设计了一个范围综述,以绘制来自患者视角的先前研究报告的患者体验的重要组成部分,贯穿整个护理过程。本范围综述的目的是确定:(i) 患者体验的关键组成部分和 (ii) 临床医生影响这种体验的策略。2022 年进行了四项主要数据库的系统搜索,并于 2023 年进行了更新,以确定描述接受择期手术的成年人整个围手术期体验的原始研究文章。提取患者报告并进行比较,以总结术前、住院期间和术后护理中患者体验的关键组成部分,并确定临床医生可以影响的患者体验组成部分。从 10 项纳入的研究中,出现了四个重要的患者体验主题,即现实期望、准确信息、一致沟通和个性化护理。临床医生影响患者体验的四个重点包括仔细监测疼痛管理、心理康复、护理协调和功能恢复。展示了临床医生如何在术前、住院期间和术后护理中影响患者体验的重要组成部分的临床医生的影响点和患者体验矩阵。本综述总结了患者在整个围手术期护理过程中的体验报告。患者体验的多维性质体现在四个患者体验主题中。临床医生可以在整个护理过程中影响患者体验的四个重点领域是理解和尊重医疗保健中人类体验的关键。对患者体验的这种动态描述可能会使临床医生更深入地了解这一复杂结构,并帮助他们与患者进行实际接触。需要进一步的工作来确保这些主题对当前和未来的患者具有足够的相关性和全面性。对于临床医生来说,制定个性化的围手术期护理策略以尊重和增强患者体验非常重要。

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