Inpatient Understanding of Their Care Team and Receipt of Mixed Messages: a Two-Site Cross-Sectional Study.
Inpatient Understanding of Their Care Team and Receipt of Mixed Messages: a Two-Site Cross-Sectional Study.
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DOI：
10.1007/s11606-023-08178-4
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发表时间：
2023-09
影响因子：
5.7
通讯作者：
Schnipper, Jeffrey L.
中科院分区：
文献类型：
--
作者：
Atkinson, Mariam Krikorian;Wazir, Mohammed;Barkoudah, Ebrahim;Khalil, Hassan;Mani, Sampathkumar;Harrison, James D.;Yao-Cohen, Erin;Weiss, Rachel;To, C.;Bambury, Elizabeth A.;Cimino, Jenica;Mora, Rosa;Maru, Johsias;Curatola, Nicole;Juergens, Nathan;Schnipper, Jeffrey L.
患者对其护理的理解，在医生参与和持续沟通的支持下，是积极健康结果的关键。然而，患者和护理团队的特点可能会阻碍这种理解。我们的目的是评估住院病人对他们的护理的理解和他们对混合信息的感知接收，以及相关的病人，护理团队和住院特征。我们于2020年2月至2021年11月期间对住院患者进行了30项调查，并纳入了患者健康记录中的其他住院数据。随机选择美国两所城市学术医院的住院患者，他们（1）接受普通医疗服务，（2）住院第三天或之后。结果测量包括（1）主要医生的知识和（2）混合信息的频率。潜在的预测因素包括平均每天记录，参与患者护理的顾问人数，单位转移人数，主治医生人数，住院时间，年龄，性别，保险类型和主要种族。共有172名患者参加了我们的调查。大多数患者不知道他们的主治医生，这个问题与他们与护理团队成员的日常互动有关。23%的患者报告至少有时会收到混合信息，最常见的是主要团队的医生和咨询医生之间的信息。然而，接收混合信息的可能性随着与护理团队成员的日常互动而降低。患者通常不知道他们的主治医生，近四分之一的人认为他们收到了关于他们护理的混合信息。未来的研究应该检查患者对他们护理的不同方面的理解，以及互动的性质，这些互动可能会提高谁负责的清晰度，同时减少收到混合信息。在线版本包含补充材料，可通过10.1007/s11606-023-08178-4获得。
Patient understanding of their care, supported by physician involvement and consistent communication, is key to positive health outcomes. However, patient and care team characteristics can hinder this understanding. We aimed to assess inpatients’ understanding of their care and their perceived receipt of mixed messages, as well as the associated patient, care team, and hospitalization characteristics. We administered a 30-item survey to inpatients between February 2020 and November 2021 and incorporated other hospitalization data from patients’ health records. Randomly selected inpatients at two urban academic hospitals in the USA who were (1) admitted to general medicine services and (2) on or past the third day of their hospitalization. Outcome measures include (1) knowledge of main doctor and (2) frequency of mixed messages. Potential predictors included mean notes per day, number of consultants involved in the patient’s care, number of unit transfers, number of attending physicians, length of stay, age, sex, insurance type, and primary race. A total of 172 patients participated in our survey. Most patients were unaware of their main doctor, an issue related to more daily interactions with care team members. Twenty-three percent of patients reported receiving mixed messages at least sometimes, most often between doctors on the primary team and consulting doctors. However, the likelihood of receiving mixed messages decreased with more daily interactions with care team members. Patients were often unaware of their main doctor, and almost a quarter perceived receiving mixed messages about their care. Future research should examine patients’ understanding of different aspects of their care, and the nature of interactions that might improve clarity around who’s in charge while simultaneously reducing the receipt of mixed messages. The online version contains supplementary material available at 10.1007/s11606-023-08178-4.
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通讯作者：
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