What Parents Say About Their Child's Surgeon Parent-Reported Experiences With Pediatric Surgical Physicians

What Parents Say About Their Child's Surgeon Parent-Reported Experiences With Pediatric Surgical Physicians
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DOI:
10.1001/jamaoto.2014.102
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发表时间:
2014-05-01
影响因子:
7.8
通讯作者:
Boss, Emily F.
Boss, Emily F.
中科院分区:
医学1区
文献类型:
--
作者:
Espinel, Alexandra G.;Shah, Rahul K.;Boss, Emily F.

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重要性 对于消费者来说,对患者和护理人员与医疗从业者的体验进行审查变得越来越重要。了解患者及其家人重视的医生素质可能有助于更有效的护理和沟通。目的 确定在孩子的门诊手术护理过程中家长重视的医生素质和护理维度。设计对患者满意度调查的评论进行混合方法分析。在城市三级医疗中心设置门诊儿科耳鼻喉科和外科专科诊所。参与者在儿科耳鼻喉科和外科专科诊所就诊并完成了主要结果和措施 调查的医生部分撰写的自由文本评论。结果 分析了来自 18 个外科专科诊所的 195 条调查评论; 64 条评论 (33%) 是全球性的,其中 58 条 (90%) 是正面的; 195 条评论中的 25 条 (13%) 讨论了护理建议。在 131 条有具体内容的评论 (67%) 中,79 条 (60%) 是正面的。主要主题是医生人际关系风格(n = 78,45%)、医生技术技能/知识/准备(n = 82,47%)和系统问题(n = 14,8%)。最常见的人际次主题是与孩子的包容/互动(20%)和对患者需求的同情/关心(29%)。最常见的技能主题与医生是否回答问题(16%)或解释治疗(23%)有关。最常见的阴性亚组是对治疗的解释不充分(18%)。大多数与系统相关的评论都是负面的(14 条中的 13 条,占 93%)。 结论和相关性 家长高度重视医生的人际交往风格和就诊特定技能(让孩子参与讨论;对患者/家人表现出同理心/关心;回答问题;解释治疗)。虽然大多数关于外科医生的评论都是肯定的,但临床系统更多的是被负面看待。关注家长报告的经历可能有助于医生改善沟通和所提供护理的整体有效性。
IMPORTANCE Reviews of patient and caregiver experience with health practitioners are increasingly important to consumers. Understanding physician qualities valued by patients and their families may facilitate more effective care and communication.OBJECTIVE To identify physician qualities and care dimensions valued by parents during their child's outpatient surgical care encounter.DESIGN Mixed-methods analysis of comments from patient-satisfaction surveys.SETTING Outpatient pediatric otolaryngology and surgical specialty clinics in an urban tertiary care center.PARTICIPANTS Parents of children seen in pediatric otolaryngology and surgical specialty clinics who completed the physician section of the patient satisfaction survey.MAIN OUTCOMES AND MEASURES Free-text comments written in the physician section of the survey.RESULTS A total of 195 survey comments from visits to 18 surgical specialty clinics were analyzed; 64 comments (33%) were global in nature, of which 58 (90%) were positive; 25 of 195 comments (13%) discussed recommendation of care. Of the 131 comments (67%) with specific content, 79 (60%) were positive. Major themes were physician interpersonal style (n = 78, 45%), physician technical skills/knowledge/preparation (n = 82, 47%), and systems issues (n = 14, 8%). The most commonly noted interpersonal subthemes were inclusion/interaction with the child (20%) and empathy/concern for the patient's needs (29%). The most common skills themes related to whether the physician answered questions (16%) or explained treatment (23%). The most common negative subgroup was inadequate explanation of treatment (18%). The majority of comments related to systems were negative (13 of 14, 93%).CONCLUSIONS AND RELEVANCE Parents highly value physician interpersonal style and visit-specific skills (involving the child in discussion; showing empathy/concern for the patient/family; answering questions; explaining treatment). While most comments about surgeons were affirmative, clinical systems were more often negatively perceived. Attention to parent-reported experiences may help physicians improve communication and overall effectiveness of care provided.