背景:COVID大流行要求住院提供者戴口罩;然而,口罩对急诊外科医师-患者关系的影响尚不清楚.我们假设戴口罩,虽然必要,作为沟通的障碍产生了负面影响,同理心,病人和外科医生之间的信任。
方法:一项横断面研究是通过用英语或西班牙语对创伤进行书面调查,急诊普外科,燃烧,2023年1月至2023年6月期间在大学一级创伤中心住院的年龄≥18岁的外科重症监护患者。患者被问到七个问题,关于他们对与手术提供者的相互作用的面具效应的看法。在5点Likert量表上对反应进行评分,并进行二值化以进行多变量逻辑回归。
结果:有188名患者完成了调查。68%的患者为男性,44%的西班牙裔,17%的人说西班牙语,年龄中位数为45-54岁。三分之一的患者同意外科医生戴口罩会使他们更难以理解外科手术的细节,并使他们在同意时不太舒服。23%的人认为更难以信任他们的提供者;年龄的增长与信任度的降低有关,优势比1.36(置信区间1.10-1.71,P=0.006)。不同性别患者的研究结果一致,种族/民族,语言,以及在COVID医院之前的经验。
结论:戴口罩,虽然重要,对创伤和急性护理手术中的患者-外科医生关系有负面影响。提供者在戴口罩时必须意识到这种效果,并努力优化与患者的沟通,以确保高质量的创伤知情护理。
BACKGROUND: The COVID pandemic has necessitated
mask-wearing by inpatient providers; however, the impact of masks on the acute care surgeon-patient relationship is unknown. We hypothesized that
mask-wearing, while necessary, has a negative impact by acting as a barrier to communication, empathy, and trust between patients and surgeons.
METHODS: A cross-sectional study was performed by administering a written survey in English or Spanish to trauma, emergency general surgery, burn, and surgical critical care inpatients aged ≥18 y at a University Level 1 Trauma Center between January 2023 and June 2023. Patients were asked seven questions about their perception of
mask effect on interactions with their surgery providers. Responses were scored on a five-point Likert scale and binarized for multivariable logistic regression.
RESULTS: There were 188 patients who completed the survey. The patients were 68% male, 44% Hispanic, and 17% Spanish speaking, with a median age of 45-54 y. A third of patients agreed that surgeon
mask-wearing made it harder to understand the details of their surgical procedure and made them less comfortable in giving consent. Twenty three percent agreed that it was harder to trust their provider; increasing age was associated with lower levels of trust, odds ratio 1.36 (confidence interval 1.10-1.71, P = 0.006). Findings were consistent among patients of different sex, race/ethnicity, language, and pre-COVID hospital experience.
CONCLUSIONS: Mask-wearing, while important, has a negative impact on the patient-surgeon relationship in trauma and acute care surgery. Providers must be conscious of this effect while wearing masks and strive to optimize communication with patients to ensure high-quality trauma-informed care.