Respectful encounters and return to work: empirical study of long-term sick-listed patients' experiences of Swedish healthcare.
Respectful encounters and return to work: empirical study of long-term sick-listed patients' experiences of Swedish healthcare.
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DOI：
10.1136/bmjopen-2011-000246
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发表时间：
2011-01-01
期刊：
影响因子：
2.9
通讯作者：
Helgesson G
中科院分区：
文献类型：
--
作者：
Lynöe N;Wessel M;Olsson D;Alexanderson K;Helgesson G
研究长期生病的病人在经历了让他们感到被尊重或被冤枉的医疗保健遭遇后，自我估计重返工作岗位的能力。采用横断面和基于问卷的调查研究长期患病患者样本（n=5802名受访者）。调查包括关于正面和负面遭遇的问题以及对这些遭遇的反应，如“感觉受到尊重”和“感觉受到委屈”。调查问卷还包括关于这些遭遇对患者重返工作能力的影响的问题。在经历过积极接触的患者中，与没有感觉到被尊重的患者（n=79）相比，那些也感到被尊重的患者（n=3327）表现出自我估计的重返工作的能力显著改善（62%（95% CI 60%至64%）vs 34%（95% CI 28%至40%））。在有负面遭遇经历的患者中，那些另外感到委屈的患者（n=993）声称与那些没有感到委屈的患者（n=410）相比，返回工作岗位的障碍明显更大（50%（95%CI 47%至53%）vs 31%（95%CI 27%至35%））。该研究表明，积极的医疗保健接触结合感觉尊重显着促进疾病缺席者的自我估计能力返回工作岗位，而消极的遭遇结合感觉委屈显着削弱它。在多大程度上可以积极和尊重医疗保健接触的影响长期生病的患者返回工作岗位的能力？在多大程度上，负面和被认为不公平的医疗保健遭遇会影响长期患病患者重返工作岗位的能力？如果医疗保健接触被认为是尊重的，长期生病的病人的自我评估能力返回工作岗位显着促进。如果医疗保健遭遇被认为是不公平的，长期生病的病人自我估计的重返工作岗位的能力会受到严重阻碍。在躯体疾病患者中，受尊重感的净效应最高，而在精神疾病患者中，受委屈感的净效应最高。研究样本很大，我们获得了相当高的回应率。结果衡量的是受访者自我估计的重返工作岗位的能力，而不是他们的实际能力。这些发现是基于长期患病患者的观点，因此可能无法普遍化。
To study long-term sick-listed patients' self-estimated ability to return to work after experiences of healthcare encounters that made them feel either respected or wronged. A cross-sectional and questionnaire-based survey was used to study a sample of long-term sick-listed patients (n=5802 respondents). The survey included questions about positive and negative encounters as well as reactions to these encounters, such as ‘feeling respected’ and ‘feeling wronged’. The questionnaire also included questions about the effects of these encounters on the patients' ability to return to work. Among patients who had experienced positive encounters, those who also felt respected (n=3327) demonstrated significantly improved self-estimated ability to return to work compared to those who did not feel respected (n=79) (62% (95% CI 60% to 64%) vs 34% (95% CI 28% to 40%)). Among patients with experiences of negative encounters, those who in addition felt wronged (n=993) claimed to be significantly more impeded from returning to work compared to those who did not feel wronged (n=410) (50% (95% CI 47% to 53%) vs 31% (95% CI 27% to 35%)). The study indicates that positive encounters in healthcare combined with feeling respected significantly facilitate sickness absentees' self-estimated ability to return to work, while negative encounters combined with feeling wronged significantly impair it. To what extent can positive and perceived respectful healthcare encounters influence long-term sick-listed patients' ability to return to work? To what extent can negative and perceived unfair healthcare encounters influence long-term sick-listed patients' ability to return to work? Long-term sick-listed patients' self-estimated ability to return to work is significantly facilitated if healthcare encounters are perceived as respectful. Long-term sick-listed patients' self-estimated ability to return to work is significantly impeded if healthcare encounters are perceived as unfair. The net effect of feeling respected was highest among patients with somatic disorders, while the net effect of feeling wronged was highest among patients with psychiatric disorders. The study sample was large and we obtained quite a high response rate. The outcome measure was the respondents' self-estimated ability to return to work, not their actual ability. The findings are based on the views of long-term sick-listed patients and so generalisation may not be possible.
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