PDF(Pubmed)
Abstract：
UNASSIGNED: In emergency medicine (EM), discerning patient expectations to inform patient-centered care poses unique challenges. We devised a novel questionnaire to facilitate clinicians\' understanding of patients\' expectations for their visit.
UNASSIGNED: We conducted a multisite, randomized controlled trial. A brief questionnaire soliciting patient expectations was developed through feedback from clinicians and patients. At the beginning of their visit, the intervention group patients completed the questionnaire and provided it to their treating clinician. The control group patients received standard care. Participants in both groups completed a survey at time of disposition assessing five satisfaction domains. The primary ordinal logistic regression analysis modeled the extent to which the intervention led to patient-reported improvement in clinician understanding of expectations with adjustment for demographic factors and site.
UNASSIGNED: Among the 308 participants, 141 intervention and 123 control exit surveys were collected. In the primary analysis, the intervention group had 2.1 times greater odds of strongly agreeing that their clinician understood their expectations (odds ratio: 2.1, 95% confidence interval: 1.2, 3.7, p-value: 0.01), roughly equivalent to a net number needed to treat of 11 for one more improved satisfaction rating. Although the secondary outcome results were not significantly different between groups, all results tended toward the intervention group having more favorable answers.
UNASSIGNED: While more patients reported that their expectations were addressed when the novel tool was used, no significant difference was found for conventional satisfaction measures. Future studies may examine whether a tool to elicit patient expectations can lead to other improved outcomes.
UNASSIGNED: We conducted a multisite, randomized controlled trial. A brief questionnaire soliciting patient expectations was developed through feedback from clinicians and patients. At the beginning of their visit, the intervention group patients completed the questionnaire and provided it to their treating clinician. The control group patients received standard care. Participants in both groups completed a survey at time of disposition assessing five satisfaction domains. The primary ordinal logistic regression analysis modeled the extent to which the intervention led to patient-reported improvement in clinician understanding of expectations with adjustment for demographic factors and site.
UNASSIGNED: Among the 308 participants, 141 intervention and 123 control exit surveys were collected. In the primary analysis, the intervention group had 2.1 times greater odds of strongly agreeing that their clinician understood their expectations (odds ratio: 2.1, 95% confidence interval: 1.2, 3.7, p-value: 0.01), roughly equivalent to a net number needed to treat of 11 for one more improved satisfaction rating. Although the secondary outcome results were not significantly different between groups, all results tended toward the intervention group having more favorable answers.
UNASSIGNED: While more patients reported that their expectations were addressed when the novel tool was used, no significant difference was found for conventional satisfaction measures. Future studies may examine whether a tool to elicit patient expectations can lead to other improved outcomes.
摘要：
■在急诊医学（EM）中，辨别患者期望以告知以患者为中心的护理带来了独特的挑战。我们设计了一种新的问卷，以促进临床医生对患者的期望的理解。
■我们进行了多站点，随机对照试验。通过临床医生和患者的反馈制定了一份征求患者期望的简短问卷。在他们的访问开始时,干预组患者填写问卷并提供给治疗临床医生.对照组患者接受标准护理。两组的参与者在评估五个满意度领域时都完成了一项调查。主要序数逻辑回归分析模拟了干预措施导致患者报告的临床医生对预期的理解改善的程度，并调整了人口统计学因素和部位。
■在308名参与者中，收集了141项干预措施和123项控制退出调查。在初步分析中，干预组有2.1倍的几率强烈同意他们的临床医生理解他们的期望（优势比：2.1，95％置信区间：1.2，3.7，p值：0.01），大致相当于治疗11所需的净数字，以提高满意度等级。尽管次要结局结果在组间没有显着差异，所有结果都倾向于干预组获得更有利的答案。
■虽然更多的患者报告说，当使用新工具时，他们的期望得到了解决，常规满意度测量结果无显著差异.未来的研究可能会检查引发患者期望的工具是否可以导致其他改善的结果。
■我们进行了多站点，随机对照试验。通过临床医生和患者的反馈制定了一份征求患者期望的简短问卷。在他们的访问开始时,干预组患者填写问卷并提供给治疗临床医生.对照组患者接受标准护理。两组的参与者在评估五个满意度领域时都完成了一项调查。主要序数逻辑回归分析模拟了干预措施导致患者报告的临床医生对预期的理解改善的程度，并调整了人口统计学因素和部位。
■在308名参与者中，收集了141项干预措施和123项控制退出调查。在初步分析中，干预组有2.1倍的几率强烈同意他们的临床医生理解他们的期望（优势比：2.1，95％置信区间：1.2，3.7，p值：0.01），大致相当于治疗11所需的净数字，以提高满意度等级。尽管次要结局结果在组间没有显着差异，所有结果都倾向于干预组获得更有利的答案。
■虽然更多的患者报告说，当使用新工具时，他们的期望得到了解决，常规满意度测量结果无显著差异.未来的研究可能会检查引发患者期望的工具是否可以导致其他改善的结果。
