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急诊科护理中负面患者体验的混合方法分析:识别整个护理过程中的挑战和循证策略

A Mixed-Methods Analysis of Negative Patient Experiences in Emergency Department Care: Identifying Challenges and Evidence-Informed Strategies Across the Care Continuum.

作者信息

Fujioka J K, Walker M, Rajab D, Bartels S A

机构信息

Department of Medicine, Queen's University, Kingston, ON, Canada.

Department of Emergency Medicine, Queen's University, Kingston, ON, Canada.

出版信息

J Patient Exp. 2025 Mar 2;12:23743735251323795. doi: 10.1177/23743735251323795. eCollection 2025.

Abstract

This mixed-methods study explores negative patient experiences within emergency departments (EDs), aiming to uncover systemic challenges and propose evidence-informed solutions. Of 2114 shared ED experiences, 306 (14.5%) were reported as "bad" or "very bad." Younger age, Indigenous status, financial instability, mental health disabilities, and non-heteronormative sexual identities were associated with negative ED experiences. Our research highlights key issues across the ED care continuum. During triage and registration, patients felt judged and perceived that their health concerns were under prioritized. Prolonged wait times contributed to feelings of neglect. During assessments, privacy concerns and lack of communication were prominent. Perceptions of misdiagnosis and stigmatization emerged as major concerns during the diagnosis and treatment phases. At discharge, insufficient follow-up and unclear instructions were frequently reported. Our findings underscore the need for improved communication, enhanced training to reduce stigma, and multi-pronged strategies to address the root causes of patient dissatisfaction. These insights can guide healthcare practitioners and policymakers in fostering a more inclusive and supportive ED environment, ultimately improving patient experiences and outcomes.

摘要

这项混合方法研究探讨了急诊科患者的负面经历,旨在揭示系统性挑战并提出基于证据的解决方案。在2114份分享的急诊科经历中,306份(14.5%)被报告为“差”或“非常差”。年龄较小、原住民身份、经济不稳定、心理健康问题以及非异性恋性身份与急诊科负面经历相关。我们的研究突出了急诊科护理连续过程中的关键问题。在分诊和登记过程中,患者感觉受到评判,认为自己的健康问题未得到优先处理。长时间等待导致被忽视的感觉。在评估过程中,隐私问题和沟通不畅较为突出。在诊断和治疗阶段,误诊和污名化的认知成为主要担忧。在出院时,经常报告后续跟进不足和指示不明确的情况。我们的研究结果强调需要改善沟通、加强培训以减少污名化,并采取多管齐下的策略来解决患者不满的根本原因。这些见解可以指导医疗从业者和政策制定者营造一个更具包容性和支持性的急诊科环境,最终改善患者体验和治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f247/11873856/ebd394b98f7e/10.1177_23743735251323795-fig1.jpg

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