以患者为中心的出院表的编码设计和共同制作对沟通和理解的影响。

Aiden Cushnahan, Boon Shih Sie, Vikas Wadhwa
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引用次数: 0

摘要

简介不良的临床结果和患者对护理的不满往往与沟通不畅有关。疾病和药物治疗等因素会影响患者的认知能力,而高估患者的健康素养可能会导致与患者就住院治疗和出院后指导进行的沟通效果不佳。改善患者对诊断和治疗的理解和回忆对于坚持治疗、随访和获得最佳临床效果至关重要。本研究旨在评估共同制作和编码的以患者为中心的出院表(PCDF)是否能提高患者对出院诊断、院内治疗和出院后计划的理解:方法:通过简单的随机抽样,从两间同样运行的普通内科病房中选择一间入院,共抽取了 111 名患者。在为期 3 个月的时间里,59 名患者接受了共同制作和编码的表格,52 名患者为对照组。在患者出院约6天后,通过盲法电话调查评估患者对诊断、院内管理、出院后指导和整体护理体验的理解:结果:接受 PCDF 治疗的患者更有可能充分理解其住院管理(P < 0.001)和出院后计划(P < 0.001)。在对诊断的理解方面,干预组和对照组之间没有明显的统计学差异。接受PCDF治疗的患者对护理有更好的理解,对入院情况也有更好的回忆:结论:使用 PCDF 与患者更好地理解医院管理和出院后指导有关。结论:PCDF 的使用提高了患者对医院管理和出院后指导的理解,同时也提高了患者的满意度。
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Impact of a codesigned and coproduced patient-centred discharge form on communication and understanding.

Introduction: Adverse clinical outcomes and patient dissatisfaction with care often have elements of poor communication. Factors such as illness and pharmacotherapy can affect cognition, and overestimation of patients' health literacy may contribute to suboptimal communication with patients regarding their hospitalisation and post-discharge instructions. Improved patient understanding and recall of their diagnoses and treatment is critical for adherence to treatment, follow-up and optimal clinical outcomes. The aim of the study was to assess whether a coproduced and codesigned patient-centred discharge form (PCDF) improves patients' understanding of their discharge diagnosis, in-hospital treatment and post-discharge plan.

Methods: A sample of 111 patients was enrolled through simple randomisation by admission to one of two identically operating general medicine wards. Over a 3-month period, 59 patients received the coproduced and codesigned form and 52 patients were controls. Assessment of patients' understanding of diagnosis, in-hospital management, post-discharge instructions and overall experience of care was undertaken by a blinded phone survey conducted approximately 6 days after discharge.

Results: Patients who received PCDF were significantly more likely to report adequate understanding of their hospital management (P < 0.001) and the post-discharge plan (P < 0.001). There was no statistically significant difference between the intervention and control groups in terms of understanding of diagnosis. Patients who received PCDF reported better understanding of care and recall of admission.

Conclusion: The use of PCDF is associated with improved patient understanding with respect to their hospital management and post-discharge instructions. It is also associated with high levels of satisfaction as assessed by measures of patient experience.

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