Patient satisfaction with HIV and TB treatment in a public programme in rural KwaZulu-Natal: evidence from patient-exit interviews.
Patient satisfaction with HIV and TB treatment in a public programme in rural KwaZulu-Natal: evidence from patient-exit interviews.
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DOI：
10.1186/1472-6963-14-32
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发表时间：
2014-01-23
影响因子：
2.8
通讯作者：
Newell ML
中科院分区：
文献类型：
--
作者：
Chimbindi N;Bärnighausen T;Newell ML
患者满意度是治疗吸收、依从性和保留性的决定因素，也是卫生系统的重要成果。排队、医护人员与患者接触的时间、工作人员的态度和设施的清洁程度可能会影响患者的满意度。我们量化了南非夸祖鲁-纳塔尔农村地区艾滋病毒和结核病患者的患者满意度维度，并确定了解释数据的潜在满意度因素。我们对300名HIV和300名结核病患者进行了患者出口访谈，他们是使用两阶段整群随机抽样方法随机抽取的，初级抽样单位(初级卫生保健诊所)是以概率比例与大小抽样的方式选择的。我们进行了因素分析来调查潜在的患者满意度因素。我们比较了对艾滋病毒和结核病服务的满意度，并通过多变量回归检验了患者满意度与患者的社会人口学特征之间的关系。据报道，几乎所有患者(95%的艾滋病毒患者，97%的结核病患者)对采访当天获得的医疗服务感到满意。然而，患者对卫生服务的具体方面的满意度大大降低：52%的艾滋病毒和40%的结核病患者同意一些工作人员没有给予患者足够的尊重(两组患者之间的差异p= 0.02)；65%的艾滋病毒和40%的结核病患者同意卫生工作者排队太长(p<； 0.001)。基于因子分析，我们确定了艾滋病毒数据和结核病数据背后的五个因素(艾滋病毒和结核病患者的可获得性、容纳性、可接受性和沟通；卫生工作者仅对艾滋病毒患者的偏好；以及仅对结核病患者的全球满意度)。满意度水平与患者的社会人口学特征没有显著差异。在这一农村地区，艾滋病毒和结核病患者对提供保健服务的具体方面的评价显示，在全球满意度评估中隐藏着极大的不满。广泛的患者满意度变量可以归结为几个基本因素，这些因素与文献中先前确定的影响获得医疗保健的概念大体一致。增加卫生系统用于艾滋病毒和结核病的资源，以及改善设施维护、工作人员态度和沟通，可能会大大提高艾滋病毒和结核病患者对他们在南非农村社区的公共部门治疗方案中得到的护理的满意度。
Patient satisfaction is a determinant of treatment uptake, adherence and retention, and an important health systems outcome. Queues, health worker-patient contact time, staff attitudes, and facility cleanliness may affect patient satisfaction. We quantified dimensions of patient satisfaction among HIV and TB patients in a rural sub-district of KwaZulu-Natal, South Africa, and identified underlying satisfaction factors that explained the data. We conducted patient-exit interviews with 300 HIV and 300 TB patients who were randomly selected using a two-stage cluster random sampling approach with primary sampling units (primary healthcare clinics) selected with probability-proportional-to-size sampling. We performed factor analysis to investigate underlying patient satisfaction factors. We compared the satisfaction with HIV and TB services and examined the relationships between patient satisfaction and patients’ socio-demographic characteristics in multivariable regression. Almost all patients (95% HIV, 97% TB) reported to be globally satisfied with the healthcare services received on the day of the interview. However, patient satisfaction with specific concrete aspects of the health services was substantially lower: 52% of HIV and 40% of TB patients agreed that some staff did not treat patients with sufficient respect (p = 0.02 for difference between the two patient groups); 65% of HIV and 40% of TB patients agreed that health worker queues were too long (p < 0.001). Based on factor analysis, we identified five factors underlying the HIV data and the TB data (availability, accommodation, acceptability and communication for HIV and TB patients; health worker preference for HIV patients only; and global satisfaction for TB patients only). The level of satisfaction did not vary significantly with patients’ socio-demographic characteristics. In this rural area, HIV and TB patients’ evaluations of specific aspects of health services delivery revealed substantial dissatisfaction hidden in the global assessments of satisfaction. A wide range of patient satisfaction variables could be reduced to a few underlying factors that align broadly with concepts previously identified in the literature as affecting access to healthcare. Increases in health systems resources for HIV and TB, but also improvements in facility maintenance, staff attitudes and communication, are likely to substantially improve HIV and TB patients’ satisfaction with the care they receive in public-sector treatment programmes in rural communities in South Africa.
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影响因子：
56.3
作者：
Baernighausen, Till;Chaiyachati, Krisda;Chimbindi, Natsayi;Peoples, Ashleigh;Haberer, Jessica;Newell, Marie-Louise
通讯作者：
Newell, Marie-Louise
影响因子：
7.7
作者：
Houlihan, Catherine F.;Bland, Ruth M.;Newell, Marie-Louise
通讯作者：
Newell, Marie-Louise
影响因子：
6.2
作者：
Jean-Pierre, Pascal;Fiscella, Kevin;Winters, Paul C.
通讯作者：
Winters, Paul C.
影响因子：
1.5
作者：
Baernighausen, Till;Tanser, Frank;Newell, Marie-Louise
通讯作者：
Newell, Marie-Louise
影响因子：
3.6
作者：
Cleary, Susan May;Birch, Stephen;Schneider, Helen
通讯作者：
Schneider, Helen