Patient perspectives of patient-provider communication after adverse events
Patient perspectives of patient-provider communication after adverse events
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DOI：
10.1093/intqhc/mzi065
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发表时间：
2005-12-01
影响因子：
2.6
通讯作者：
Staton, EW
中科院分区：
文献类型：
--
作者：
Duclos, CW;Eichler, M;Staton, EW
客观的。探讨实际不良医疗事件后患者对医患沟通的看法，因为之前的患者错误研究很少基于真实情况。设计。我们使用半结构化指南进行了四次患者焦点小组讨论。我们使用编辑方法分析文字记录来识别主题。设置。科罗拉多州的三个地点。研究参与者。参与者是从全州范围的伤后计划中招募的。有目的的抽样始于某个地理位置的患者；我们联系了所有其他患者（最多 50 名）。 22 名患者最初同意参加； 16名成人参与，代表13个病例。结果。解决尝试涉及复杂的问题和流程。有效的沟通是不良事件后职业关系能否继续的一个重要因素。沟通的性质和质量影响患者将事件定义为“诚实的错误”还是“错误”。预期并发现了两种类型的创伤（身体和情感）。第三个（财务）发现并在某些情况下证明了影响患者后续行动的最显着因素。关怀、诚实、快速、个性化和重复的提供者响应与患者满意度相关。结论。提供者沟通的及时性和质量对患者对不良事件的反应有重要影响。共同应对不良医疗事件可以帮助患者和医疗服务提供者缓解患者的情感、身体和经济创伤，并最大限度地减少通常经历的愤怒和沮丧。卫生组织、提供者、调查人员和政策制定者在制定提供者培训或评估患者解决过程时应考虑患者的体验。
Objective. To explore patient perceptions of patient-provider communication after an actual adverse medical event because prior patient error studies are rarely based on real situations.Design. We conducted four patient focus groups using a semi-structured guide. We analyzed transcripts using an editing approach to identify themes.Setting. Three sites in Colorado.Study participants. Participants were recruited from statewide post-injury program. Purposeful sampling began with patients in a geographic location; we contacted every other patient (up to 50). Twenty-two patients initially agreed to participate; 16 adults participated, representing 13 cases.Results. Complex issues and processes were involved in resolution attempts. Effective communication was an important factor in whether professional relationships continued after an adverse event. The communication nature and quality influenced whether patients defined event as 'honest mistake' or 'error'. Two types of trauma (physical and emotional) were expected and found. A third (financial) uncovered and proved in some cases the most salient factor influencing patients' subsequent actions. Caring, honest, quick, personal, and repeated provider responses were linked to patient satisfaction.Conclusions. Provider communication timeliness and quality were important influences on patients' responses to adverse events. Confronting an adverse medical event collaboratively helped both patients and providers with patients' emotional, physical, and financial trauma and minimized the anger and frustration commonly experienced. Health organizations, providers, investigators, and policymakers should consider the patient experience when developing provider training or evaluating processes in patient resolution.