恐惧在医疗保健设置,神话或现实:在毛里求斯私营医疗保健部门的案例研究

Dr. Catriona Planel-Ratna, Dr. Thanika Devi Juwaheer
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引用次数: 0

摘要

本文的目的是调查患者的恐惧和因素,可能会引发这种现象在毛里求斯的私人医疗保健设置。考虑采用混合方法来实现研究目标。研究样本包括27名医疗保健专业人员和411名私人医疗保健客户(患者)。定量和定性数据收集分别采用一份包含11个患者恐惧属性的量表和一个开放式问题。采用描述性统计、单因素方差分析和扎根理论方法对数据进行分析。结果显示,病人的恐惧是一个现实和低估的方面护理在毛里求斯的私人医疗保健设置。引起患者恐惧的主要因素是治疗费用、支付账单的能力和治疗结果等。正确理解这些因素并相应地调整服务交付被认为是有效管理患者恐惧的关键,但其他结果表明,这种恐惧反而被私人医疗机构利用。患者越来越意识到,在某些情况下,私人医疗保健专业人员甚至会引发或加剧他们的恐惧,这些专业人员试图说服他们快速、昂贵地购买更多的服务。因此,护理的其他重要方面,如患者信任和患者依从性被发现受到不利影响。不同年龄、不同收入群体患者的恐惧程度差异也有统计学意义。该研究可作为指南,确保在整个医疗保健服务过程中有效管理患者恐惧的最佳措施可以确定和应用,从而确保以诚实,公平和值得信赖的方式处理更知情的患者。例如,结果强调了医疗保健提供者在与患者打交道时保持人情味的重要性,以努力减轻他们的恐惧,并创造合理的积极体验,而不管治疗结果如何。单因素方差分析和Tukey HSD事后检验的结果揭示了年龄、收入等简单因素对患者恐惧程度的影响。这意味着医疗保健提供者应该确保他们开发和采用不同的方法来有效地处理患者的恐惧,而不是试图开发和采用“一刀切”的方法。此外,建立的“恐惧处理机制”在他们的服务文化中根深蒂固,不仅是为了防止对护理的其他重要方面产生不利影响,包括患者信任和患者依从性,而且主要是为了优化患者的旅程。该研究还试图通过揭示通常引发这种现象的主要因素以及最常见的恐惧相关行为,提高人们对私人医疗机构中患者恐惧的认识。该研究还强调了公众不放弃接受医疗保健服务的权利的重要性,因为适当承认和管理他们的恐惧被视为提供护理的基本方面。重要的是要理解,尽管管理患者的恐惧很重要,但在这样做时保持以患者为中心的方法同样重要。该研究不仅测量了患者的恐惧程度,而且通过定性数据从患者的角度获得了对恐惧的独特见解。医疗保健组织最终可以相应地调整其服务交付,以优化患者体验。
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Fear in Healthcare Settings, Myth or Reality: A Case Study of the Private Healthcare Sector in Mauritius
The purpose of this paper is to investigate patient fear and the factors that could possibly trigger this phenomenon in Mauritian`s private healthcare settings. A mixed-methods approach was considered to fulfilling the research aim. The research sample comprised 27 healthcare professionals and 411 private healthcare customers (patients). A scale with 11 patient fear attributes and one open-ended question were used in quantitative and qualitative data collection respectively. Descriptive statistics, One-way ANOVA and Grounded Theory method were used to analyze the data. The results reveal that patient fear is a reality and an underestimated aspect of care in Mauritian`s private healthcare settings. Major factors causing patient fear to arise are the cost of the treatment, the ability to pay the bill and the treatment outcome among others. Properly understanding those factors and adjusting the service delivery accordingly were considered to be crucial in effectively managing patient fear, however other results suggest that such fear is instead being exploited by private healthcare organizations. Patients are becoming increasingly aware that their fears are even in certain cases being triggered or aggravated by private healthcare professionals in an attempt to convince them to purchase more services quickly and expensively. Consequently, other important aspects of care such as patient trust and patient compliance were found to be adversely affected. Moreover statistically significant differences in the degree of fear between patients of different age groups and income groups were also obtained. The study acts as a guide to ensure that the best measures to efficiently manage patient fear throughout the healthcare delivery can be determined and applied thus ensuring to deal with better-informed patients in an honest, fair and trustworthy manner. For instance results highlight the importance for healthcare providers to preserve human touch when dealing with patients in an effort to alleviate their fears and create reasonably positive experiences irrespective of the treatment outcome. Results following One-Way ANOVA analysis and Tukey HSD post hoc test exposed the difference in degree of fear between patients based on simple factors such as age group or income group. This implies that healthcare providers should ensure that they develop and adopt different approaches to handle patient fear effectively and not attempt to develop and adopt a ‘one size fits all’ approach. Moreover that the 'fear handling mechanism' established is ingrained in their service culture not only to prevent adverse effects on other vital aspects of care including patient trust and patient compliance but also and mostly to optimize the patient journey. The study also attempts to increase awareness about patient fear in private healthcare settings by exposing the major factors that normally trigger this phenomenon as well as the most common fear-related behaviors. The study moreover highlights the importance for the public to not relinquish their rights to receiving healthcare services whereby proper acknowledgement and management of their fears are regarded as fundamental aspects of care delivery. It is vital to comprehend that although managing patient fear is important, maintaining a patient-centric approach in doing so is as important. The study not only measures the level of patient fear but it also offers, through the qualitative data obtained unique insights on fear from the patient's perspective. Healthcare organizations can eventually adjust their service delivery accordingly to optimize the patient experience.
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