全科诊疗过程中的插话:对医生的负面影响和患者的冷漠态度。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-08-14 DOI:10.1093/fampra/cmac129
Catarina Neves Santos, Bruno Ferreira Pedrosa, Marília Martins, Fábio Gouveia, Fátima Franco, Margarida João Vardasca, Bernardo Pedro, Jorge Domingues Nogueira
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引用次数: 0

摘要

背景:中断会影响会诊时间、医生和患者的满意度以及所提供护理的质量。虽然大多数中断似乎都有负面影响,会影响医患关系,干扰临床推理,从而增加出错的风险,但目前仍没有证据表明中断对会诊的整体影响:评估全科诊疗过程中中断的次数和持续时间。比较医生和患者对其紧迫性和影响的看法,以及对会诊的总体满意度:方法:对一家医疗中心具有代表性的年度面对面全科咨询样本进行横断面研究。2022 年 1 月至 3 月期间,我们在会诊后向医生和患者发放了匿名问卷。我们进行了描述性和推论性统计分析:结果:共纳入 403 次问诊。医生报告的中断次数多于患者(108 次对 87 次,P < 0.001)。从患者的角度来看,这些中断更紧急(34.5%),而从医生的角度来看(20.6%;P = 0.029)。患者低估了中断对会诊的影响(7.1%的中断对患者有负面影响,而对医生有负面影响的中断占 24.7%;P < 0.001)。咨询中断不会影响患者对咨询的满意度(P = 0.135),但会降低医生对咨询的满意度(P = 0.003):结论:医生对会诊中断的批评更多,对其发生率的认识更高,更经常地报告其负面影响,从而导致对中断会诊的满意度降低。患者则不重视中断咨询的发生,不关心其对安全或隐私的影响,他们的满意度也不会受到中断咨询的影响。
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Interruptions during general practice consultations: negative impact on physicians, and patients' indifference.

Background: Interruptions can impact consultation duration, doctors and patients' satisfaction, and quality of care provided. Although most of them seem to have a negative impact, affecting doctor-patient relationship and interfering with clinical reasoning, which increases the risk of error, there is still no evidence on their global impact on consultations.

Objectives: To evaluate the number and duration of interruptions during general practice consultations. To compare physicians and patients' perceptions of their urgency and impact, as well as the overall satisfaction with the consultation.

Methods: Cross-sectional study of a representative sample of annual face-to-face general practice consultations at a Health Centre. Between January and March 2022, anonymous questionnaires were given to physicians and patients after consultation. We performed a descriptive and inferential statistical analysis.

Results: A total of 403 consultations were included. Physicians reported more interruptions than patients (108 vs. 87, P < 0.001). From patients' perspective those interruptions were more urgent (34.5%) compared with physicians' perspective (20.6%; P = 0.029). Patients undervalued their impact on consultations (7.1% of interruptions with a negative impact among patients vs. 24.7% among doctors; P < 0.001). Interruptions did not interfere with patients' satisfaction with consultation (P = 0.135) but were associated with lower physicians' satisfaction with consultation (P = 0.003).

Conclusion: Physicians are more critical regarding consultations interruptions, being more aware of their incidence and reporting more often a negative impact, which translates into lower satisfaction with interrupted consultations. Patients devalue the occurrence of interruptions, showing no concern about their impact on security or privacy, and their satisfaction is not affected by them.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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