Testing a new theory of patient satisfaction with treatment outcome
Testing a new theory of patient satisfaction with treatment outcome
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DOI：
10.1097/01.mlr.0000132394.09032.81
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发表时间：
2004-08-01
期刊：
影响因子：
3
通讯作者：
Wright, JG
中科院分区：
文献类型：
--
作者：
Hudak, PL;Hogg-Johnson, S;Wright, JG
目标：患者对治疗结果满意度的理论尚未在医疗机构中得到开发和测试。本研究的目的是测试一种将患者满意度与体现（身体与自我统一）联系起来的新理论，并与其他竞争理论进行比较。设计：我们进行了一项前瞻性队列研究。背景：这项研究是在一家三级护理医院进行的。患者：我们研究了 122 名接受选择性手部手术的个体。方法：根据以下因素（代表 7 种满意度理论）检查手术后约 4 个月对治疗结果的满意度：1）总体临床结局，2）患者先验的自我选择的重要临床结局，3）远见预期，4）事后预期，5）心理状态，6）结局不佳者的心理状态，7）实施。分析：首先使用单变量分析，然后进行多变量回归分析检验七个假设。结果：对治疗结果的满意度与实施显着相关。三个混杂因素——手术成功解决患者手术最重要原因的程度、事后预期以及工人的补偿——也很重要。最终模型解释了治疗结果满意度多维测量中 84% 的差异。结论：这项研究表明，通过制定改善身体自我统一性的策略，以及引出和解决患者接受治疗的最重要原因，可以促进对治疗结果的满意度。
Objectives: Theories of patient satisfaction with treatment outcome have not been developed and tested in healthcare settings. The objectives of this study were to test a new theory linking patient satisfaction and embodiment (body-self unity) and examine it in relation to other competing theories.Design: We conducted a prospective cohort study.Setting: This study was conducted at a tertiary care hospital.Patients: We studied 122 individuals undergoing elective hand surgery.Methods: Satisfaction with treatment outcome approximately 4 months after surgery was examined against the following factors (representing 7 theories of satisfaction): 1) overall clinical outcome, 2) patients' a priori self-selected important clinical outcomes, 3) foresight expectations, 4) hindsight expectations, 5) psychologic state, 6) psychologic state in those with poor outcomes, and 7) embodiment.Analysis: Seven hypotheses were tested first using univariate analyses and then multivariable regression analysis.Results: Satisfaction with treatment outcome was significantly associated with embodiment. Three confounders-the extent to which surgery successfully addressed patients' most important reason for surgery, hindsight expectations, and workers' compensation-were also significant. The final model explained 84% of the variance in a multidimensional measure of satisfaction with treatment outcome.Conclusion: This research suggests that satisfaction with treatment outcome could be facilitated by developing strategies to improve body-self unity, and eliciting and addressing the patient's most important reason for undergoing treatment.