住院患者满意度调查分析

目的 分析患者对医疗服务满意度评价的影响因素。 方法 对2006年、2007年每年3、6、9、12月份的8个时段在院的4 387位患者进行断面满意度调查,采用拉网式问卷调查,对其中387名投诉患者或家属采取面对面访谈,对提出的问题讨论并整改,在下一轮调查中追踪满意度走向。 结果 患者满意度存在极强的模糊性,易生成错误的满意率。影响患者对医院服务满意度评价的因素依次为:服务态度不好占22.8%,医护人员医疗技术不高占 22.4 %;医药费太高占21.1%;住院环境不宜人占19.5%;其它占14.2%。患者对医院服务态度好的评价依次为:耐心倾听患者诉说占12.8% ;技术好,及时解除痛苦占40.8%;责任心强、看病认真占30.6 % ,对患者热情、主动占15.8%。 结论 可靠的医疗技术和良好的服务态度是影响患者对医院服务满意度评价最重要的两个因素,耐心倾听患者诉说是影响医务人员服务态度的最重要因素。     

住院患者600例满意度影响因素调查与对策

目的:通过对临沂市人民医院600例住院患者满意度进行调查,分析影响住院患者满意度的因素,为医院管理者提出合理化建议.方法:运用文献法初步确定调查的各项指标,采用调查问卷调查临沂市人民医院的住院患者600例,对影响患者满意度因素进行分析,并指出有针对性的对策.结果:在此次的调查结果中,住院患者对医院的医疗服务态度、医疗技术水平、医疗设施、医患沟通、后勤服务和医疗费用的满意度超过80.0%,而对医院治疗效果达到91.7%,对医院的总体满意度达到93.7%,说明医院得到了住院患者的认可.结论:该院住院患者的满意度比较高,特别体现在治疗效果方面;住院患者对医疗服务态度、医疗技术水平、医疗费用和医患沟通的认可,对医院满意度有积极作用;医院的后勤服务会影响住院患者对医院的满意程度;住院患者满意度的调查对改善医院医疗服务质量,提高医院管理效益有明显的促进作用.     

重视工休座谈信息反馈

我科在开展整体护理的同时 ,围绕“以病人为中心”的服务宗旨 ,重视工休座谈信息反馈 ,及时协调解决病人提出的不满意的问题 ,最大程度地满足了病人的合理需求 ,提高了住院病人对医院工作的满意度。现介绍如下。1　一般资料2 0 0 0年 7月～ 2 0 0 1年 6月 ,我科共召开工休会 16次 ,参加座谈的病人及家属达 40 0余人次 ,收到各种信息反馈2 0余条 ,其中不满意信息 7条。主要的不满意因素有 :医护人员的服务态度、工作责任心、操作技术、医疗费用问题、催赶陪客、工友的服务态度、到辅助科室检查等候时间长等。2　措施2 1　重视工休会信息反馈…     

杭州市听力障碍患者就医体验现状调研

目的了解杭州市听力障碍患者的就医体验现状。方法基于PZB理论模型、运用问卷对156例患者进行就医期望与实际体验的调查,采用个案访谈方法对145例患者家属及57名医护人员进行访谈。结果听力障碍患者就医过程中,期望与实际体验差异最明显的维度为"沟通",实际得分最高为"防感染意识"。听力障碍患者家属期望与实际体验差异在医疗技术和诊疗态度这两个方面较小,而对沟通方面较不满意。医护人员期望与实际体验差异最显著的是沟通时间和沟通方式。结论听力障碍患者就医过程中体验与期望差距最大的方面为沟通,医护人员在提供服务的过程中需要注意沟通的方式和技巧,提高沟通效果。     

护理不安全因素分析与防范对策

随着社会的进步,人们的法制观念及自我保护意识不断提高,患者及家属对就医的正当权益都有了更深刻的了解和认识,对医疗质量、护理质量、医疗护理安全提出了更高的要求。为制定可行的安全防范措施,强化管理,给患者提供高质量的服务,减少不安全的发生,作者就护理不安全因素的原因分析及相应的防范对策做一简单综述。1护理不安全因素分析1.1护理服务态度欠佳服务态度差是主要不安全因素,如工作中使用服务忌语,不注意谈话的方式和语气,回答问题简单导致患者误解等[1]。如果护士缺乏对患者及家属的理解,不顾及服务态度,忽视患者心理需求,就达不到…     

乳腺癌术后患者伤口置管居家照护促进因素和障碍因素的质性研究

目的：通过对乳腺专科医护人员质性研究的视角,了解乳腺癌术后患者伤口置管居家照护的促进因素和障碍因素,以便为患者提供更加人性化的伤口置管居家照护服务。方法：采用现象学研究方法,以半结构式访谈方式对天津医科大学肿瘤医院乳腺科的19名医护人员进行深入访谈,进行现场录音和笔录,并采用分析软件Nvivo12.0及Colaizzi 7步法对访谈资料进行整理、分析。结果：患者伤口置管居家照护促进因素包括获得良好的家庭和社会支持、多元化及个性化的健康教育形式;障碍因素包括患者因素（自愿学习能力与认知不足及依从性差）、照护者因素（老年患者家属照护者及更换家属监管照护）和其他因素（独居患者及地域因素）。结论：作为临床医护人员应为患者主动提供针对性专业指导及信息支持,以解决其实际问题,帮助患者安全度过伤口置管居家期,减少并发症的发生,促进康复,进而提高其生活质量。     

住院病人自动出院的原因分析及对策

医疗市场竞争日益激烈,网络资讯的普及,使当前在城乡大小医院住院病人自动出院者有增无减,各家医院都应积极探寻相关原因及对策,使患者遵从医嘱的出院率上升。此文从医护人员服务态度差、医疗技术水平低等7个方面分析了住院病人自动出院的原因;又从创建良好的医院服务品牌,提供最优质的医疗服务等7个方面阐述了对策。     

ICU护患纠纷原因分析及对策

2001年1月~2005年1月,我们对23例ICU护患纠纷的相关因素进行分析并制定防范措施,效果满意。现报告如下。1一般资料23例护患纠纷中护理不到位15例,服务态度差、工作责任心不强3例,对业务技术不满意2例,对收取费用有疑义2例,其他1例。2原因分析2.1患者及家属方面2.1.1不能接受病情突然变化由于患者病情危重,病情经常发生突然变化,家属往往从医护方面寻找原因,尤其是当进行一项新的治疗时病情突然发生变化,家属很容易对新的治疗产生质疑,由此引发纠纷。2.1.2对医疗护理结果期望值过高ICU集中了全院最好的医疗资源,先进的抢救设备和专职的医…     

危重患者抢救过程中护患纠纷原因分析对策

2001年1月~2005年4月,对我院危重患者抢救时所发生的护患纠纷进行了回顾性调查,并对其原因进行了分析和总结,提出相应的防范对策,以期能减少护患纠纷,提高护理服务质量。1临床资料20例护患纠纷中,11例反映服务态度差,占55%;对业务技术不满意2例,占10%;工作责任心不强2例,占10%;对抢救设备不满意1例,占5%;死亡后患者处理不满意2例,占10%;其他2例。2原因分析2.1服务态度差调查分析的结果显示,护士服务态度差是引发护患纠纷的主要原因。主要因患者病情重,家属反复找医护人员,而护士认为家属小题大做,表现为对患者及家属态度生硬、缺乏耐心、甚…     

失地安置社区医患关系影响因素研究

目的 通过对失地安置社区医患双方的调查,了解失地安置社区医患关系的影响因素,以便提高失地安置社区医疗服务水平,构建和谐医患关系.方法 运用失地安置社区医患关系调查问卷对失地安置社区284名医护人员和381例患者进行调查.结果 失地安置社区医患双方的医患关系走向认定比较差异具有统计学意义（P＜0.01）.医患关系影响因素中,患者认定的前3位影响因素是：医疗费用、门诊和住院的便利、医护人员的工作态度;医护人员认定的前3位影响因素是：患者的经济状态、患者病情的严重程度、患者对医护人员的信任度.患者对医患关系走向认定的影响因素包括门诊和住院的便利、医疗费用、医护人员与您之间的沟通和医院的人性化服务,医护人员对医患关系走向认定的影响因素包括患者对医护人员的信任度和患者受教育程度.结论 失地安置社区医患关系影响因素双方各不相同,具有特殊性,需要针对性地健全失地农民医疗保障和加强社区医院管理,促进和谐医患关系建立,保持社区社会稳定.     

Is emergency open chest cardiopulmonary resuscitation accepted by patients' families?

Emergency open chest cardiopulmonary resuscitation (OCCPR) is sometimes performed on patients with cardiopulmonary arrest (CPA), especially those resulting from trauma. Since OCCPR is frequently carried out without the permission of patients' families, we surveyed the opinions of the families. A total of 1058 CPA patients were transferred to our department during the last 15 years. We sent questionnaires individually to the families of these patients to ask their opinions about OCCPR. The questionnaire provided the six questions allowing multiple answers; (1) Do you unconditionally agree with OCCPR? (2) Do you agree with OCCPR in children? (3) Do you agree with OCCPR in elderly patients? (4) Do you agree with OCCPR without permission from patient's families? (5) Do you entrust OCCPR to the doctors in charge? and (6) others. The questionnaire reached 846 families, of which 277 (32.7%) responded. The percentage response to each question was (1) 70.2, (2) 5.8, (3) 21.8, (4) 7.1, (5) 4.2 and (6) 5.0%. The younger the age of the responders the more they agreed with OCCPR. All the responders less than 30 years old agreed with the procedure. Of the 277 families, 95 had CPA patients treated with OCCPR. This group of families responded to six questions at the following rates: (1) 79.5, (2) 6.0, (3) 13.3, (4) 2. 4, (5) 4.8 and (6) 4.8%, suggesting that families with OCCPR patients are more cooperative to our treatment than those with non-OCCPR patients. The results of this study suggest that OCCPR in CPA patients is generally accepted by the patients' families, especially by young generations, although post-OCCPR careful explanation to patients' families is still indispensable.     

Swedish women's satisfaction with medical and emotional aspects of antenatal care

AIM: This paper reports a study to investigate how satisfied Swedish women are with their antenatal care. BACKGROUND: Medical care is of high priority, but other aspects, such as psychosocial support are also important for women during pregnancy. Identifying women who are dissatisfied with their antenatal care could help us to improve this. Methods. A national cohort of 2746 Swedish-speaking women completed a questionnaire in early pregnancy and at 2 months postpartum. The data were collected in 1999-2000. RESULTS: The majority of participants were satisfied with their antenatal care, but 23% were dissatisfied with the emotional aspects and 18% with the medical aspects. The strongest predictors of dissatisfaction were women's opinions that midwives had not been supportive and had not paid attention to their partners' needs. If the women believed that there were not enough antenatal visits or had met three or more midwives during their antenatal visits, they were more likely to be dissatisfied with the care received. Those with low levels of education were more likely to be dissatisfied with both medical and emotional aspects of antenatal care. CONCLUSIONS: Midwives working in antenatal care should support pregnant women and their partners in a professional and friendly way in order to increase satisfaction with care. Organizing teamwork with no more than two midwives taking care of a woman during a normal pregnancy could make women feel more supported by their midwives.     

Visitation in critical care: processes and outcomes of a performance improvement initiative

When family members became dissatisfied with a restrictive visiting policy in a combined coronary and medical intensive care unit, this situation was seen as an opportunity to better meet patient and family needs. A review of the literature indicated that open visitation policies enhance patient and family satisfaction, while a survey of patients, families, and health care team members revealed a desire for a more open visitation policy. Nursing staff, with input from other disciplines, developed and implemented a less restrictive visitation policy. Post-intervention surveys revealed higher patient and family satisfaction and a marked decrease in formal complaints.     

医护患对实施预立医疗照护计划的态度及影响因素调查

目的调查粤北地区某三级甲等医院医护人员、恶性肿瘤患者及家属对实施预立医疗照护计划的态度及影响因素。方法采用自行设计的问卷,调查本院210名医护人员、105名恶性肿瘤患者家属及103例恶性肿瘤患者对预立医疗照护计划的态度及影响因素。结果医护人员、家属及患者对预立医疗照护计划的认知率分别为16.7%、9.5%及6.8%;赞同实施率分别为85.7%、51.4%及88.3%。不同文化程度、宗教信仰、住院经历及丧亲原因的家属对预立医疗照护计划的态度差异有统计学意义(P0.05)。医护人员、家属及患者支持实施预立医疗照护计划原因不一,其中选择较多原因为疾病长期折磨、临终时应减轻痛苦等;不支持实施预立医疗照护计划的原因医护人员选择较多为没有法律支持、应救死扶伤,家属选择较多为伦理道德问题,患者选择较多为有事未了。结论不同地区医护人员、患者及家属对预立医疗照护计划认知程度可能不同,医护人员及患者对实施预立医疗照护计划态度较家属更认可和支持,多因素影响实施预立医疗照护计划态度,实施时需综合考虑社会道德观念及法律等问题。     

The impact of perceived medical dominance on the workplace satisfaction of Australian and British nurses

Current literature on the sociology of health views medical dominance as a structural feature of the health division of labour, and a body of literature has developed exploring the structural components contributing to the subordination of the allied health professions In this paper, nursing literature describing the nature and source of nurses' perceptions, complaints and dissatisfactions with their profession, and sociological analyses of the position of nurses within the structure of the health care delivery system, were employed to provide a framework for assessing the degree to which structural medical dominance of the nursing profession impinges on nurses' perceptions of dominance and how these perceptions affect nurses' workplace satisfaction A 69-item questionnaire covering aspects of doctor-nurse, doctor-patient, nurse-patient and nurse-hospital administration relationships was developed One-hundred and thirty-three Australian nurses and 108 British nurses completed the questionnaire, in which they ranked their own level of professional satisfaction and the level of satisfaction they perceived doctors to experience Results indicated that Australian and British nurses were not only dissatisfied with many aspects of then- work environment, such as their pay and working conditions, but also experienced dissatisfaction with their professional status while perceiving the medical profession to be highly satisfied British nurses were significantly more dissatisfied with their own profession and perceived the medical profession to be more authoritarian than did Australian nurses No difference between Australian and British nurses' perceptions of degree of medical autonomy was found The implications of nurses' perceived discrepancy in workplace satisfaction between nurses and doctors in the delivery of health care are discussed in terms of the structural barriers created by medical dominance Recommendations for the trainmg of nurses and the implications of the findings for nurse practitioners are made, together with suggestions for further research     

精神分裂症患者及其家属对住院知情同意权的态度及影响因素

目的探讨精神分裂症患者及其家属对患者住院知情同意权的态度及其影响因素。方法对符合CCMD-3的精神分裂症患者及其法定监护人各986例,进行患者知情同意和入院方式的相关调查。结果家属让患者对住院知情387例(39.2%),不让知情599例(60.8%);患者同意入院249例(25.3%),不同意入院737例(74.7%)。影响患者享有住院知情权的因素是:监护人态度和患者的性别、MOAS总分、自身攻击因子分、体力攻击因子分、有攻击行为、PANSS总分、P分、SI分、G分;影响患者自愿入院的因素是:监护人态度和患者MOAS总分、体力攻击因子分、SI分、P分、G分和攻击行为。结论目前精神分裂症患者对住院的知情同意率和自愿入院率仍很低;监护人和患者的特征都影响患者家属对患者知情同意权的态度;精神分裂症患者住院与否主要取决于监护人的态度;保证监护人的知情同意权是解决患者住院和减少医疗纠纷的关键。     

Making sense of cancer

Nurses caring for patients with cancer do so at varying stages of the disease trajectory from diagnosis to death. Having an understanding of cancer biology, potential causes and classification should enable you to understand the treatment options and to communicate more effectively with patients, their families and friends.     

ICU成立多民族地区患者家属沟通小组的实践

目的探讨通过成立多民族地区重症监护室(ICU)患者家属沟通小组,促进医患有效沟通,提升患者社会支持系统对医疗行为的认识及参与。方法成立由5人组成的ICU患者家属沟通小组,成员进行为期1个月的相关沟通技巧、民族习俗、各民族基本生活用语、口语等方面的培训,并制定沟通计划,要求成员掌握回、藏、撒拉族基本生活用语,分布在白班与夜班,使其与家属沟通具有连续性,贯穿在患者住ICU全过程。结果患者家属与医务人员沟通有效,获取医疗信息渠道通畅,对ICU医护人员工作认可,服务满意度较之前提高了7.9%,达93.2%。结论通过成立多民族地区ICU患者家属沟通小组,构建优质护理服务链,提高了护患沟通效果,增进患者家属对医护人员的理解、信任,能达到医患和谐的社会要求。     

Relation between post-stroke satisfaction with time use,perceived social support and depressive symptoms

Purpose. To determine if perceived level of social support and number of depressive symptoms differentiates those who are satisfied with their time use post-stroke from those who are dissatisfied.

Method. Secondary analysis of data of 54 subjects grouped by yes/no responses to ‘Are you satisfied with how you spend your time?’ Perceived social support and number of depressive symptoms were evaluated using the MOS Social Support Scale and Geriatric Depression Scale respectively.

Results. Time use satisfaction was high (64.8%). Dissatisfied subjects reported lower affectionate support and fewer positive social interactions (t < ?2.70, p < 0.009) as well as higher levels of depression (t = 2.06, p = 0.05). Dissatisfied subjects were more likely to endorse only three Geriatric Depression Scale items (i.e., ‘dropped activities’, ‘often bored’, and ‘often felt helpless’) (χ²(1) > 7.27, p < 0.007).

Conclusions. Persons post-stroke who are dissatisfied with their time use may not be depressed but may benefit from participation in meaningful social occupations.     

脑卒中康复中的自我状态分析

由于脑卒中康复过程较长、效果不显著,脑卒中患者在康复过程中容易表现出对家人过度依赖、对自己能力不自信以及与医护人员沟通不畅等问题,这些问题实际上是因为他们没有展现恰当的自我状态,不能与医护人员、家人开展健康的沟通,这对脑卒中的康复极其不利。所谓自我状态是指个体的心态以及相应的行为模式。本文运用沟通分析理论中的自我状态概念,描述脑卒中患者自我状态发生的变化,同时分析患者与家人、医护人员之间的自我状态交流模式,以帮助患者觉察自己的自我状态,并适当地表现出来,开展健康的交流,最终促进疾病的康复。