Yuan Jie, Chen Xiao, Yang Chun, Chen JianYou, Han PengFei, Zhang YuHong, Zhang YuXia
School of Nursing, Fudan University, Shanghai, 200032, People's Republic of China.
Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, 200032, People's Republic of China.
Patient Prefer Adherence. 2025 Jul 16;19:2027-2037. doi: 10.2147/PPA.S526623. eCollection 2025.
Open-ended questions in patient experience surveys provide a valuable opportunity for people to express and discuss their authentic opinions. The analysis of free-text comments can add value to quantitative measures by offering information which matters most to patients and by providing detailed descriptions of the service issues that closed-ended items may not cover.
To extract useful information from large amounts of free-text patient experience comments and to explore differences in patient satisfaction and loyalty between patients who provided negative comments and those who did not.
We collected free-text comments on a broad, open-ended question in a cross-sectional patient satisfaction survey. We adopted a mixed-methods approach involving a literature review, human annotation, and natural language processing technique to analyze free-text comments. The associations of patient satisfaction and loyalty scores with the occurrence of certain patient comments were tested via logistic regression analysis.
In total, 28054 free-text comments were collected (comment rate: 72.67%). The accuracy of the machine learning approach and the deep learning approach for topic modeling and sentiment analysis was 0.98 and 0.91 respectively, indicating a satisfactory prediction. Participants tended to leave positive comments (69.0%, 19356/28054). There were 22 patient experience themes discussed in the open-ended comments. The regression analysis showed that the occurrence of negative comments about "humanity of care", "information, communication, and education", "sense of responsibility of staff", "technical competence", "responding to requests", and "continuity of care" was significantly associated with a worse patient satisfaction and loyalty, while the occurrence of negative comments about other aspects of healthcare services had no impact on patient satisfaction and loyalty.
The results of this study highlight the interpersonal and functional aspects of care, especially the interpersonal aspects, which are often the "moment of truth" during a service encounter when patients critically evaluate hospital services.
患者体验调查中的开放式问题为人们表达和讨论真实意见提供了宝贵机会。对自由文本评论的分析可以通过提供对患者最重要的信息以及对封闭式项目可能未涵盖的服务问题进行详细描述，为定量测量增添价值。
从大量自由文本患者体验评论中提取有用信息，并探讨给出负面评论的患者与未给出负面评论的患者在患者满意度和忠诚度方面的差异。
我们在一项横断面患者满意度调查中收集了关于一个广泛的开放式问题的自由文本评论。我们采用了一种混合方法，包括文献综述、人工标注和自然语言处理技术来分析自由文本评论。通过逻辑回归分析测试患者满意度和忠诚度得分与某些患者评论出现情况之间的关联。
总共收集了28054条自由文本评论（评论率：72.67%）。用于主题建模和情感分析的机器学习方法和深度学习方法的准确率分别为0.98和0.91，表明预测效果令人满意。参与者倾向于给出正面评论（69.0%，19356/28054）。开放式评论中讨论了22个患者体验主题。回归分析表明，关于“关怀的人性”“信息、沟通与教育”“工作人员的责任感”“技术能力”“回应请求”和“护理连续性”的负面评论的出现与较差的患者满意度和忠诚度显著相关，而关于医疗服务其他方面的负面评论的出现对患者满意度和忠诚度没有影响。
本研究结果突出了护理的人际和功能方面，尤其是人际方面，这往往是服务过程中患者批判性评估医院服务的“关键时刻”。
