How well informed are patients when leaving the emergency department? comparing information provided and information retained
How well informed are patients when leaving the emergency department? comparing information provided and information retained
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DOI：
10.1136/emermed-2011-200451
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发表时间：
2013-01-01
影响因子：
3.1
通讯作者：
Zimmermann, Heinz
中科院分区：
文献类型：
--
作者：
Marty, Hans;Bogenstaetter, Yvonne;Zimmermann, Heinz
研究目的急诊科（艾德）出院患者应全面、准确地了解诊断、未来检查和随访护理。本研究调查：（1）出院时医生告知患者的全面程度;（2）出院后患者对这些信息的记忆有多准确;（3）患者离开艾德时的总体知情程度;（4）知情程度是否与患者满意度相关。（1）在出院谈话期间给出的信息，基于谈话的音频记录，（2）患者对该信息的回忆的准确性，基于出院后的访谈在这些访谈中，作者还评估了（3）治疗期间提供的信息的数量和准确性。此外，作者获得了（4）医生和患者的满意度评分。结果83%的出院谈话提供了足够的信息。患者正确回忆了82%的诊断信息，56%的计划检查信息和72%的后续治疗信息。与药物相关的信息最容易被遗忘或歪曲。总的来说，43%的患者离开艾德正确地了解诊断，计划的检查和随访。患者满意度高（平均4.7分的5点李克特量表），不相关的informedness的patient.Conclusions患者有重要的信息赤字时，离开艾德，和信息的传输需要改善。医生与病人的出院谈话似乎是一个理想的机会，以提高病人的知情权。需要标准化出院程序，并培训医生如何确保患者真正理解所提供的信息。
Study objective Patients discharged from the emergency department (ED) should be informed comprehensively and accurately about the diagnosis, future examinations and follow-up care. This study investigates: (1) how comprehensively patients are informed by physicians on discharge; (2) how accurately patients remember this information after discharge; (3) how well informed overall patients leave the ED; and (4) whether informedness relates to patient satisfaction.Methods This study compares: (1) information given during discharge conversations, based on audio recordings of the conversations, with (2) accuracy of patient recall of this information, based on postdischarge interviews. During these interviews, the authors also assessed (3) amount and accuracy of information provided during treatment. Furthermore, the authors obtained (4) satisfaction ratings by physicians and patients. Data were collected for 96 patients during 20 shifts.Results Sufficient information was provided in 83% of discharge conversations. Patients correctly recalled 82% of information received about diagnosis, 56% about examinations planned and 72% about follow-up treatments. Information related to medication was most prone to forgetting or distortion. Altogether, 43% of the patients left the ED correctly informed about diagnosis, planned examinations and follow-up. Patient satisfaction ratings were high (mean 4.7 on a 5-point Likert Scale) and not related to informedness of the patient.Conclusions Patients had important information deficits when leaving the ED, and information transmission needs to be improved. The physician-patient discharge conversation seems an ideal opportunity for enhancing patient informedness. Standardisation of discharge procedures and training physicians in how to ensure that patients actually understand the information provided are needed.