Patient satisfaction with physician care

Patient satisfaction is known to be related to many desired outcomes in medical care. This study employees multidimensional scaling techniques to identify factors affecting satisfaction with physician care in 1,210 patients. Stepwise regression analysis of factors that met predetermined criteria showed that accessibility explained the greatest amount of variance in patient satisfaction. The patient's perceived efficacy of physician care and greater continuity of care also have significant correlations with satisfaction. Perceived susceptibility to illness, utilization of physician services, and levels of education have lesser but significant effects on patient satisfaction. Despite methodological constraints, economic and psychological benefits make evaluation of patient satisfaction an important exercise.     

基于灰色模糊理论的病人满意度测评信息系统设计

病人满意度是评价医院服务质量、改进医院工作的重要工具之一,因此,病人满意度测评信息系统就成为医院信息化一个非常重要的方面。但满意度本身存在很多不确定性,为使测评结果更趋于客观和真实,基于灰色模糊理论设计了病人满意度测评信息系统,并介绍了系统的结构、主要功能和采用的数学理论。系统结合灰色关联方法和模糊理论建立综合评价模型,用多层次模糊综合评判方法进行满意度评价,采用等时距GM（1,1）模型进行灰色系统预测。     

论普外科患者的健康教育

普外手术病人的健康教育应始终贯穿于整个疾病的全过程,基层医院所面对的手术病人,文化层次差别大,如何做到高质量的整体护理,健康教育是关键的一环。普及宣传卫生科学知识,满足患者健康教育需求,显得尤为重要。健康教育是为病人解决健康问题的手段之一,是整体护理的重要组成部分,通过对普外科患者的健康教育及护理,可以降低并发症的发生率,提高病人对护理工作的满意度,促进疾病的早日康复。     

患者术后家庭延续护理模式研究

目的：探讨患者术后家庭延续护理模式,提高患者的生活质量,降低患者因住院带来的经济负担。方法100例患者术后3-4d出院,出院后视病情5-7d行家庭访视、伤口换药、拆线、健康指导等,对患者的健康行为、家庭护理需求、满意度等项目进行问卷调查。并行3-6月电话随访。结果切口 I期愈合率〈99%,伤口感染率为0;患者的住院费用降低25-30%;教育覆盖率达到100%;患者家属满意率〈95%;患者的健康行为形成率达到90%以上。结论术后患者家庭延续护理是医院工作的重要组成部分,降低了住院费用与医疗成本,促进了患者康复。     

Rehabilitation in older people: know more, gain more

Functional decline is common among older patients during or even prior to hospitalisation, in spite of treatment of acute illnesses. An effective rehabilitation programme is vital to improve the motor and functional states of the older patients. Knowing factors affecting rehabilitation of older persons is important for their effective and efficient rehabilitation. This article, with special reference to local studies, examines age, gender, cognitive function, and serum albumin levels as to how they influence rehabilitation in the elderly. The conclusion is that we should not exclude patients of advanced age from rehabilitation programmes, based on poor cognitive function and low serum albumin levels as they can achieve similar gains in motor and functional outcomes. A nutritional programme to improve the albumin level of older persons could speed up the rehabilitation progress, rendering it more efficient. A gender-specific rehabilitation programme is needed to improve functional outcome in men and motor outcome in women. Moreover, knowing the factors influencing residential care home placement affords an opportunity to reduce reliance on institutionalisation after rehabilitation.     

全口义齿四手操作配合及患者满意度调查

目的：探讨全口义齿制作过程中四手操作护理配合要点及患者的满意度。方法选择行全口义齿修复患者64例,按照全口义齿四手操作护理配合要点参与修复治疗全过程,调查患者满意度。结果（1）患者对全口义齿制作过程中护理操作、医护配合、人文关怀、护理态度评价为满意分别占98．4％、96．9％、93．8％、100．0％。（2）患者对全口义齿外观、语言、咀嚼能力、义齿稳固性、舒适性评价为满意分别占90．6％、98．4％、89．1％、93．8％、96．9％。（3）患者预期目的完全达到58例（90．6％）;基本达到6例（9．4％）。结论四手操作在全口义齿诊疗中可提高医生工作效率和患者满意度,并减轻医护工作的疲劳;应积极提倡培养口腔护士四手操作的能力。     

急性胰腺炎患者手术治疗护理体会

目的:探讨对急性胰腺炎患者采取手术治疗的护理体会。方法:回顾我院收治的急性胰腺炎患者120例,均经血生化检查、B超或CTC检查符合急性胰腺炎诊断标准,其中急性水肿性胰腺炎34例,急性出血坏死性胰腺炎86例。对患者采取手术治疗,术后严密监测患者的各项生命体征,给予抗感染、引流灌注、营养支持等精心的治疗和护理。结果:患者经过手术治疗和护理后,总有效率为96.67%,3例患者由于并发多器官衰竭,治疗无效而死亡,1例患者死于休克,患者对护理的满意程度较高。结论:对手术治疗的患者采取积极有效的护理,密切观察患者的各项生命体征,做好患者日常基本护理,能够减少患者并发症的发生,促进患者康复。     

Patients 21 days or more in an acute hospital bed: Appropriateness of care

Patients occupying beds for 21 days or more in acute hospitals were studied. Using predetermined objective criteria, the appropriateness of the previous day’s hospitalisation was assessed. Barriers to appropriate care and the level of care required were identified in those deemed inappropriate. Of the 421 patients identified, 194 were considered to be inappropriately placed in an acute hospital bed. Patients deemed inappropriate were more likely to be older (p<0.05), female (p<0.05), have lost a spouse (p<0.05), have been admitted through the Accident and Emergency Department (p<0.05), and have longer lengths of stay (p<0.001) than those considered appropriate. The most frequently identified barrier to appropriate care (N=143) was that the patient was awaiting another level of care. The level of inappropriate use of acute beds in Dublin is unacceptably high. Additional longstay accommodation especially for geriatric patients is needed. Alternatives to acute hospital care for patients requiring rehabilitation or nursing care should be explored.     

相关领域专家对缺血性脑卒中居家康复效果评价看法与建议的质性研究

背景　开展居家康复是降低缺血性脑卒中复发率和致死率、改善患者预后、减轻我国卒中负担的必然趋势,而客观评价缺血性脑卒中患者居家康复效果有助于居家康复方案的良性、持续改进,但目前关于缺血性脑卒中患者居家康复效果评价的研究报道少见。目的　了解相关领域专家对缺血性脑卒中患者居家康复效果评价的看法与建议,为进一步构建缺血性脑卒中居家康复效果评价体系提供参考依据。方法　采用立意抽样法,于2020年10-12月邀请来自全国7个省市的缺血性脑卒中居家康复领域的护理管理专家、神经内科临床专家及康复专家共22名作为受访者。采用描述性现象学研究方法,对受访者进行面对面半结构式深度访谈。采用Colaizzi七步分析法、Nvivo 12质性研究软件分析访谈资料,提炼主题。结果　共提炼出4个主题：（1）开展缺血性脑卒中患者居家康复效果评价是医患双方共同的迫切需求;（2）缺血性脑卒中患者健康结局是居家康复效果评价的核心内容;（3）知-信-行水平是缺血性脑卒中患者居家康复效果评价的重要维度;（4）应根据患者自身特点灵活开展缺血性脑卒中患者居家康复效果评价工作。结论　患者的健康结局、患者及其主要照顾者的知-信-行水平是缺血性脑卒中患者居家康复效果评价的重点。建议组建多学科联合的专业团队,细化各团队成员职责与分工,提高评价团队的专业水平,提高评价结果的准确性和效率;加强信息化建设,搭建区域内多元合作平台,推动缺血性脑卒中患者居家康复效果评价工作顺利开展。     

优质护理服务在精神科病房应用的效果评价

目的:探讨优质护理服务在精神科病房的应用以及实施优质护理服务对护理效果的影响。方法:选取我科一个优质护理服务示范病区为实验组,一个普通病区为对照组。2011年1～9月,实验组应用新制定的服务标准,并改变护理模式;对照组采用传统服务标准及护理模式对患者实施护理。结果:对两组患者住院期间的满意度调查评价指标进行对比,差异有统计学意义(P<0.01或P<0.05)。结论:实施优质护理服务是提高患者满意度和赢得医疗市场的重要保证,也是以人为本、以患者为中心,消除疾病痛苦,恢复患者身心健康,满足患者需要的新的服务理念。患者满意度提高,护患关系和谐,护理质量明显提高。     

Enhancing Quality of Patients Care and Improving Patient Experience in China with Assistance of Artificial Intelligence

Improving health of Chinese people has become national strategy according to the Healthy China 2030. Patient experience evaluation examines health care service from perspective of patients; it is important for improving health care quality. Applying artificial intelligence (AI) in patient experience is an innovative approach to assist continuous improvement of care quality of patient service. A nursing quality platform based on patient experience data which is empowered by AI technologies has been established in China for the purpose of surveillance and analysis of the quality of patient care. It contains data from nearly 1300 healthcare facilities, based on which portraits of nursing service qualities can be drawn. The patient experience big data platform has shown potentials for healthcare facilities to improve patient care quality. More efforts are needed to achieve the goal of enhancing people's sense of health gain.     

Patient satisfaction after total knee arthroplasty: an Asian perspective

INTRODUCTION

Total knee arthroplasty (TKA) is an effective method for alleviating pain and restoring knee function in patients with severe osteoarthritis. However, despite the improvements in surgical technique and postoperative care, it has been reported that up to 19% of patients are dissatisfied after their operations. The aim of this study was to evaluate patient satisfaction levels after TKA in an Asian cohort, as well as assess the correlation between patient satisfaction levels and the results of traditional physician-based scoring systems.

METHODS

The medical data of 103 Asian patients who underwent 110 TKAs between December 2008 and June 2009 were obtained from our hospital’s Joint Replacement Registry. The minimum follow-up period was one year and patient expectations were assessed before TKA. Patient satisfaction was assessed postoperatively using a 5-point Likert scale. Reasons for patient dissatisfaction were recorded. Standardised instruments (e.g. the Knee Society Score, the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] and the generic Short Form-36 health survey) were used to assess the patient’s functional status and the severity of symptoms pre- and postoperatively.

RESULTS

Among the 110 TKAs performed, 92.8% resulted in patient satisfaction. Patient satisfaction correlated with postoperative WOMAC function scores (p = 0.028), postoperative WOMAC final scores (p = 0.040) and expectations being met (p = 0.033).

CONCLUSION

Although there was a high level of patient satisfaction following TKA in our cohort of Asian patients, a significant minority was dissatisfied. Patient satisfaction is an important outcome measure and should be assessed in addition to traditional outcome scores.     

Measuring Patient Satisfaction of the Quality of Health Care: A Study of Hospitals in Turkey

Patient satisfaction is an important measure of service quality in health care systems. Patients' perceptions about health care systems seem to have been largely ignored by health care managers in developing countries. The aim of this study is to develop a reliable and valid instrument to measure patient satisfaction in Turkey. A questionnaire was developed and a total of 1100 patients in 31 different hospitals were interviewed. Factor analysis was utilized to determine the factor structure. The instrument of the patient satisfaction developed in this study provides insights to the researches who study the improvement of patient satisfaction with service quality of hospitals, practitioners, and the decision makers.     

Improved life satisfaction and pain reduction: Follow-up of a 5-week multidisciplinary long-term pain rehabilitation programme

Background.Multidisciplinary rehabilitation programmes can improve physical functioning and help patients with long-term pain back to work. Little is known, however, of the extent to which such rehabilitation also affects life satisfaction, pain severity, and disability. We wanted to evaluate if a 5-week rehabilitation programme for patients with long-term pain improves life satisfaction and decreases pain severity and disability.

Methods. The subjects were 164 patients aged 18–65 years from a pain rehabilitation clinic. Most of them were referred from primary care units. One group of repeated tests was used. Participants were asked to fill out the LiSat-11 checklist and parts of the Multidimensional Pain Inventory (MPI), including pain severity, at admission, at discharge, and 1 year after the rehabilitation programme.

Results. Satisfaction with life as a whole, and six of ten LiSat-11 domains improved during the follow-up, though none reached the levels for the general population. MPI subscales pain severity, pain interference, life control, and affective distress improved, whereas no change was observed for general activity. Patients older than 38 years decreased more in MPI affective distress than younger patients. Gender, pain severity, and work status before the programme did not significantly influence the outcome.

Conclusions. The results indicate that multidisciplinary rehabilitation improves life satisfaction, reduces pain severity, and reduces negative psychological, social, and behavioural effects of pain. These outcome variables relate to domains known to be of interest for patients and should therefore be considered for evaluation of rehabilitation programmes for long-term pain.     

围手术期综合护理在翼状胬肉切除术中应用效果分析

目的 探讨围手术期综合护理在翼状胬肉术中应用效果分析。方法 选取2022年5～7月中国科学技术大学附属第一医院（安徽省立医院）行翼状胬肉切除伴结膜瓣移植术的翼状胬肉患者102例,将2022年5月12日至6月24日收治的51名患者作为对照组,将2022年6月27日至7月25日收治的51名患者作为试验组。试验组患者在常规护理基础上实施围手术期综合护理干预,对照组患者实施常规护理,比较两组患者术后的疼痛、焦虑、抑郁、护理满意度及不良反应发生率。结果 试验组患者疼痛程度明显低于对照组,差异有统计学意义（P<0.05）。试验组患者焦虑、抑郁程度明显低于对照组,差异有统计学意义（P<0.05）,试验组患者护理满意度高于对照组（98.04%比84.31%）,两组患者术后的不良反应发生率比较,差异无统计学意义（P>0.05）。结论 围手术期综合护理应用于翼状胬肉切除伴结膜瓣移植术患者的疗效确切,能够促进患者术后康复,提升患者术后满意度。     

综合康复护理模式在颈性眩晕患者中的应用研究

目的 探讨综合康复护理模式在颈性眩晕患者中的应用及效果.方法 北京康复医院骨科收治的71例颈性眩晕患者被随机分为对照组35例和试验组36例,对照组采用常规治疗与护理,试验组在常规治疗与护理基础上实施综合康复护理,比较两组患者的治疗与护理效果,总结其护理经验.结果 试验组的总有效率、患者满意度高于对照组(P＜0.05),而试验组的眩晕复发率低于对照组(P＜0.05).结论 综合康复护理模式可以有效提高颈性眩晕患者的治疗效果,减少其复发,并可提高患者的满意度.     

患者满意度调查及门诊护理质量改进的效果分析

目的对患者满意度进行调查，观察本院护理质量改进的效果。方法调查对象2628人，采用患者满意度调查表，对护理中存在的问题进行改进前后的患者满意度比较。结果共有252份（8．6％）问卷反映不满意问题，其中护理因素和管理因素分别为99份（3．8％）、153份（5．8％），实施护理质量改进后患者的满意度与实施护理质量改进前比较明显提高，差异有显著性（P〈0．05）。结论对患者及家属进行护理满意度调查，有利于及时地发现并改进护理中存在的问题，有利于护理质量的提高。     

全膝关节置换术后关节挛缩患者的护理及康复疗效探讨

目的：该研究旨在通过对比全膝关节置换（TKA）术后关节挛缩患者住院康复和门诊康复的疗效,探讨护理对TKA术后关节挛缩患者的康复疗效的影响。方法2010—2013年间该院收治TKA术后关节挛缩患者44例,随机分为住院组20例和门诊组24例,分别行团队康复和单纯功能康复治疗。治疗前、后及6个月随访时分别行满意度和西安大略和麦克马斯特大学骨关节炎指数评分（WOMAC）评价。结果相比门诊组,住院组治疗后和6个月随访时的满意度更高（P〈0.05）;住院组的治疗后和6个月随访时的WOMAC评分更高（P〈0.05）;住院组并发症更少。结论对于TKA术后关节挛缩患者,以功能康复和医学护理为主的团队康复比单纯功能康复效果更好,患者满意度更高,医学护理可能有助于减少TKA术后关节挛缩患者的并发症。     

Patients' satisfaction with reproductive health services at Gogo Chatinkha Maternity Unit, Queen Elizabeth Central Hospital, Blantyre, Malawi

Patient satisfaction is an individual''s state of being content with the care provided in the health system. It is important for reproductive health care providers to get feedback from women regarding satisfaction with reproductive health services. There is a dearth of knowledge about patient satisfaction in Malawi.

Aim

The specific objective of the study was to determine the extent to which women are satisfied with the care they receive when they come to deliver at the Queen Elizabeth Central Hospital maternity unit.

Methods

A cross sectional study of postpartum women using interviewer administered semi-structured questionnaires was conducted between November 2008 and May 2009. The questionnaires captured mainly quantitative data.

Results

1562 women were interviewed. Most women were housewives (79%) who were referred from Health Centres within the city. Ninety five percent delivered a live baby. The majority of women (97.3%) were satisfied with the care they received from admission through labour and delivery and the immediate postpartum period. Most women cited doctors'' and nurses'' reviews (65%) as what they liked most about the care they received during their stay in the unit.Most women expected to receive efficient and definitive care. The women''s knowledge on patient''s rights was extremely low (16%) and equally very few women were offered an opportunity to give an opinion regarding their care by the doctors and nurses in the maternity unit.

Conclusion

Most women who deliver at the hospital are satisfied with the care offered. This satisfaction is mainly due to the frequent reviews of patients by nurses and doctors in the unit. There is a great need to educate both the population of women served and the health workers that serve them on patient''s rights.     

REINVESTING HOSPITAL WASTE – A MASTER PLAN FOR DEVELOPMENT OF PATIENTS

It is a general observation that hospital stay is dull and boring. It is mainly because the patients remain unoccupied. Their time is wasted. It is more so in service hospitals where apparently trivial cases are admitted for prolonged periods. A development programme for the patients by reinvesting their own wasted seconds may generate revolutionary progress in patient care.KEY WORDS: Managing patients'' time, Patients development programme