Patient Satisfaction in Turkey: Differences between Public and Private Hospitals

This article reports the results of a patient-satisfaction survey administered by interview to 2045 adults discharged from several major public and private hospitals in Turkey. The direct measurement of patient-satisfaction is a new phenomenon for this country. An instrument was designed similar to those available in the United States and administered during exit interviews. Two primary areas of analyses were determined in comparing services provided by these public and private hospitals: demographic factors with regard to accessibility and consumer perceptions of the quality of service provided. Relationships and percentages within and among the five public and two private hospitals are reported. Several statistically significant differences were found between the hospitals, with the private hospitals achieving the greatest satisfaction on most of the quality of services issues examined. Future recommendations outline the need to take into account the public's perception of these hospitals and enhancing customer satisfaction as a means of increasing service utilization.     

Beyond Demographics: Differences in Patient Activation Across New Immigrant, Diverse Language Subgroups

The federal government promotes “patient-centered medical homes” to plan care with respect to patients’ cultures and values and support patients’ self-care efforts. To promote self-care, the medical home would be best utilized by activated, engaged patients. The objective of this study was to measure and compare patient activation scores in English-, Spanish-, and Haitian Creole-speaking patients seen at an inner-city hospital ambulatory care practice. Patient activation was measured using the patient activation measure (PAM). Mean PAM scores and activation levels differed according to survey language (p < 0.001). US-born participants had higher mean PAM scores than persons born outside of the US. Participants living in the US longer had higher mean PAM scores than participants newer to the US. Levels of activation and mean PAM scores increased with greater comfort reading, speaking, and thinking in English. The mean PAM (SD) score of 61.5 (16.5) for Haitian Creole-speaking Caribbean Blacks was significantly lower than the mean PAM score of 68.8 (15.6) for English-speaking Caribbean Blacks (p value = 0.006). Although mean PAM scores did not significantly differ between Haitian Creole and Spanish speakers, PAM stages differed according to language of survey completion (p < 0.001), with a greater percentage of Haitian Creole speakers being categorized as stage 1 (least activated) as well as stage 4 (most activated). Spanish and Haitian Creole speakers have lower mean PAM scores than English speakers. Mean PAM scores did not differ between Hispanics and non-Hispanics or according to race, illustrating the need to examine the role of language and culture on patient activation.     

医疗知情同意书的完善与应用

医疗知情同意书是医疗法律文书 ,是卫生部《病历书写基本规范》的新要求。在提高认识和加深理解的基础上 ,完善了知情同意的系列文书并应用于临床 ,收到了良好效果。     

Written Informed Consent for Participation in a Study and Reduction in Consent Rate

Background

The association between the method of obtaining informed consent and the consent rate in a cohort study, as well as the differences between consenters and non-consenters with regard to blood-sample donation are unclear.

Methods

We measured the consent rates among 64-year-old residents who underwent medical checkups in a city for a cohort study consisting of a questionnaire survey and blood-sample donation and determined the influence of different approaches to informed consent and the participants’ characteristics on the consent rates.

Results

Of 3,098 residents who underwent medical checkups over 10 years, 99.2% responded to the questionnaire survey, and 92.5% agreed to blood-sample donation. The consent rate for blood-sample donation after obtaining individual written informed consent was lower than that observed with the general-announcement approach. Differences in the consent rates for participation in the questionnaire study were, however, negligible. A higher percentage of men than women consented to donate blood samples. After adjustments for gender, it was observed that individuals with a history of hypertension and those without depression consented to blood-sample donation significantly more frequently.

Conclusion

The consent rate for blood-sample donation to the study decreased when the opt-in approach with written consent was used. This decrease may introduce consent bias, and the method of obtaining informed consent should be revised.Key words: Informed Consent, Consent Rate, Medical Check-up     

建立以人为本的新型知情同意模式构建和谐医患关系

构建和谐医患关系是构建社会主义和谐社会的重要内容，而医患沟通不够、医患之间缺乏信任和理解等是影响医患关系的重要因素。知情同意是加强医患沟通、增强医患相互信任的重要方式。我们应从生物-心理-社会医学模式的要求出发，通过加强医务人员的医德修养，提高沟通技巧；建立和完善知情同意制度，深化知情同意的内涵；设置和完善心理咨询专科，加强人性化的知情沟通；探索新型知情同意模式；建立和完善医患沟通监督机制和投诉处理制度等．让患者作出更自主、更充分的知情选择，构建和谐的医患关系。     

Re-engaging Dropouts of Prolonged Exposure for PTSD Delivered via Home-Based Telemedicine or In Person: Satisfaction with Veteran-to-Veteran Support

The Journal of Behavioral Health Services & Research - This paper describes feasibility of and patient and peer satisfaction with a Veteran-to-Veteran peer support program purposefully...     

落实“知情权”医患双方需注意的几个问题

患者的自决权是指头脑正常的成年患者对自己的身体和财产享有的自我决定权。患者自决权的理念是由法学领域渗透至医学领域的 ,那种认为医生能为患者作出最好决策的观点现在已不再通行。患者的自决权包括二层意义 ,第一 ,患者对自己的身体有自主权—患者有权从医方知道自己身体的真实情况 (医方估计患者知情后会引起不良后果的 ,可将实情告知患者家属或其他相关人 ) ,同意或拒绝对他的身体作医学检查和治疗。第二 ,是患者在接受医疗技术服务时 ,对自己的财产享有自主权 ,具体表现为在患方知道病情的前提下 ,尽量让其了解医疗行情 ,从而自愿、…     

论病人"知情同意权"的回归及在医患关系中的价值

知情同意权是病人最基本的权利，医患双方对病人权利的主张尊重均未触及到权利的核心部分，这是造成医患矛盾的症结。随着医疗自主时代的来临，病人知情同意权的回归可以预防和减少医疗纠纷，提高医疗服务品质，同时也是相关法律法规得以充分履行贯彻的表现。     

Requiring Consent vs. Waiving Consent for Medical Records Research: A Minnesota Law vs. the U.S. (HIPAA) Privacy Rule

The use of medical records in research can yield information that is difficult to obtain by other means. When such records are released to investigators in identifiable form, however, substantial privacy and confidentiality risks may be created. These risks become more common and more serious as medical records move to an electronic format. In 1996, the state of Minnesota enacted legislation with respect to consent requirements for the use of medical records in research. This legislation has been widely criticized because--it is claimed--it creates an unnecessary impediment to research. In this article, we show that these arguments rest upon misinterpretation and/or misrepresentation of the 1996 legislation. A consent requirement had actually been present in Minnesota since 1976 (though codified in a patient rights statute rather than a privacy statute). The 1996 law does not require specific consent, as often claimed, but rather only a general authorization. The campaign against the Minnesota legislation appears to have been motivated by concern with respect to the then impending federal privacy rule. The HIPAA rule, as enacted, is in fact less stringent with respect to consent than the Minnesota consent law. On the other hand, the Minnesota consent law has not been effectively applied or enforced. As we change the way we manage sensitive medical information, new efforts are needed to provide protection against the confidentiality risks in research. Patient consent is an important tool in this regard. New instrumentalities are needed to solicit and document consent.     

实施知情同意工作中的常见问题与对策

本文概述了知情同意权的历史渊源与法律认识，总结分析了当前临床实践中实施知情同意过程中的常见问题及其原因，提出了建立和完善知情谈话制度、推广使用《医患知情谈话记录单》等具体措施，认为这些措施不仅从形式到内容均体现了对患者知情同意权的尊重和保护，而且同时对医疗机构和医务人员自身也具有自我保护的法律效力，有助于在构建和谐医患关系方面达到双赢。     

Informed Consent in School Health Research: Why, How, and Making It Easy

The obligation to obtain informed consent for student participation in health-related research creates a complex set of legal, ethical, and administrative responsibilities because the interests of research integrity are delicately balanced against protection of human subjects. Even the term itself sparks a range of responses depending on one's perspective and stake in the process. This paper traces the historical impetus behind obtaining informed consent, identifies key elements comprising informed consent, and reviews types of consent procedures used in schools. The authors suggest 20 ways to boost response rates while providing a realistic level of informed consent for school-based studies.     

Improving Patient Satisfaction in Health Care Clinics Through the Use of a Focus Group Approach

No abstract available for this article.