Patients' and carers' perceptions of safety in rural general practice
Patients' and carers' perceptions of safety in rural general practice
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DOI：
10.5694/mja14.00193
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发表时间：
2014-07-21
影响因子：
11.4
通讯作者：
Dunbar, James A.
中科院分区：
文献类型：
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作者：
Hernan, Andrea L.;Walker, Christine;Dunbar, James A.
目的：探讨农村全科医疗的患者和护理人员的经验，以确定他们对护理安全的看法。设计、参与者和环境：2012年9月至12月期间，在维多利亚州西南部对26名农村患者和护理人员进行了四次焦点小组访谈。从当地联合健康自我管理计划和一个母亲团体中招募了经常使用全科医生的人。对焦点小组进行录音，使用叙事方法对笔录进行独立分析和解释。结果：经历过某种程度伤害的参与者能够更广泛地评论护理的安全方面。通过对所有参与者叙述的分析，确定了与安全相关的几个关键主题。在全科医生中，假设的安全感占主导地位，并受到参与者风险意识水平和对全科医生的信任程度的影响。其他独特的主题包括脆弱的感觉，对解释和道歉的渴望，对错误的宽容态度，以及对全科医生人际交往能力的偏好。结论：本研究揭示了影响患者和护理人员对安全观点的因素，并证明了将患者声音纳入安全研究的价值。由于信任的默认位置而假定的安全感，加上有限的风险感知，直接挑战了当前关于患者参与安全的文献。需要进一步探索，以确定患者和护理人员如何有效地参与和协助提高一般实践的安全性。
Objectives: To explore patients' and carers' experiences of rural general practice to identify their perceptions of safety of care.Design, participants and setting: Four focus group interviews were conducted with 26 rural patients and carers in south-west Victoria between September and December 2012. Frequent users of general practice were recruited from Local allied health self-management programs and a mothers' group. Focus groups were audio recorded, transcripts were independently analysed and interpreted using narrative methodologies.Results: Participants who had experienced some Level of harm were able to comment more extensively on safety aspects of care. Several key themes related to safety were identified from the analysis of all participant narratives. An assumed sense of safety in general practice was predominant, and was influenced by participants' Level of risk awareness and trust in their general practitioner. Additional unique themes included feelings of vulnerability, desire for an explanation and apology, a forgiving view of mistakes, and preference for GP interpersonal skills over competence.Conclusions: This study revealed new insights into the factors that influence patients' and carers' perspectives of safety, and demonstrated the value of incorporating the patient voice into safety research. An assumed sense of safety due to a default position of trust, coupled with Limited risk perception, directly contests the current Literature on patient involvement in safety. Further exploration is required to determine how patients and carers can effectively engage in and assist with improving safety in general practice.