-
Journal of Immigrant and Minority Health Aug 2019Individuals with limited English proficiency (LEP) face barriers to safe and high-quality health care. 'Patient-experience' is increasingly viewed as an important... (Review)
Review
Individuals with limited English proficiency (LEP) face barriers to safe and high-quality health care. 'Patient-experience' is increasingly viewed as an important component of health care quality. However, the impact of language proficiency on 'patient-experience' is not well-described. This scoping review mapped the literature on the patient experience of individuals with LEP. We reviewed sixty qualitative and mixed-methods studies from EMBASE and MEDLINE published between 2007 and 2017. We identified four major themes: (1) Communication, language barriers, and health literacy, (2) Relationships with health care professionals, (3) Discrimination and intersection with other dimensions of identity, and (4) Cultural safety. We also identified factors that may improve LEP patient experience, including: mitigating language barriers through interpretation or language-concordant providers, offering translated patient resources, and educating health care professionals about cultural safety.
Topics: Communication; Communication Barriers; Cultural Characteristics; Health Literacy; Humans; Limited English Proficiency; Patients; Prejudice; Professional-Patient Relations
PubMed: 30203377
DOI: 10.1007/s10903-018-0816-4 -
Palliative & Supportive Care Oct 2023In palliative care, effective communication is essential to adequately meet the needs and preferences of patients and their relatives. Effective communication includes... (Review)
Review
OBJECTIVES
In palliative care, effective communication is essential to adequately meet the needs and preferences of patients and their relatives. Effective communication includes exchanging information, facilitates shared decision-making, and promotes an empathic care relationship. We explored the perspectives of patients with an advanced illness and their relatives on effective communication with health-care professionals.
METHODS
A systematic review was conducted. We searched Embase, Medline, Web of Science, CINAHL, and Cochrane for original empirical studies published between January 1, 2015 and March 4, 2021.
RESULTS
In total, 56 articles on 53 unique studies were included. We found 7 themes that from the perspectives of patients and relatives contribute to effective communication: (1) open and honest information. However, this open and honest communication can also trigger anxiety, stress, and existential disruption. Patients and relatives also indicated that they preferred (2) health-care professionals aligning to the patient's and relative's process of uptake and coping with information; (3) empathy; (4) clear and understandable language; (5) leaving room for positive coping strategies, (6) committed health-care professionals taking responsibility; and (7) recognition of relatives in their role as caregiver. Most studies in this review concerned communication with physicians in a hospital setting.
SIGNIFICANCE OF RESULTS
Most patients and relatives appreciate health-care professionals to not only pay attention to strictly medical issues but also to who they are as a person and the process they are going through. More research is needed on effective communication by nurses, in nonhospital settings and on communication by health-care professionals specialized in palliative care.
Topics: Humans; Palliative Care; Hospice and Palliative Care Nursing; Patients; Adaptation, Psychological; Communication
PubMed: 37646464
DOI: 10.1017/S1478951523001165 -
International Journal of Environmental... Sep 2020In the context of population aging, enhancing the health of older patients has become an urgent issue for public health. Health education and health literacy need to be...
In the context of population aging, enhancing the health of older patients has become an urgent issue for public health. Health education and health literacy need to be further understood from the healthcare providers' standpoint to increase older patients' effective application of such information into their daily lives. We aimed to further understand nurses' perspectives on the education of older patients and their health literacy, as nurses are one of the frontline providers interacting with older patients. In total, 16 nurses and nurse practitioners who had 5 or more years of clinical experience participated. Data were collected via face-to-face interviews and emails. Data analysis followed the thematic analysis suggested by Braun and Clarke. Five themes emerged from the analysis, as follows: attitudes that are hard to change; physical and cognitive functional barriers to understanding teaching materials; family caregivers-surrogate vs. gatekeeper; major contexts that moderate the elderly's health literacy; and strategies to enhance teaching effectiveness and health literacy. These findings illustrate the conditions pertinent to communication with older adults from the patients', providers' and healthcare delivery viewpoints. Systemic assistance and interventions specialized for older patients and their healthcare providers need to be developed and tested to improve clinical practice and patient health literacy.
Topics: Adult; Aged; Female; Health Literacy; Health Personnel; Humans; Nurses; Patients
PubMed: 32899759
DOI: 10.3390/ijerph17186455 -
BMJ Open Sep 2021Patient satisfaction is an important indicator of hospital healthcare quality. Little up-to-date information of patient satisfaction in China is available. This study...
OBJECTIVES
Patient satisfaction is an important indicator of hospital healthcare quality. Little up-to-date information of patient satisfaction in China is available. This study attempts to gain a holistic understanding of patient satisfaction in China and identify the key antecedents of patient satisfaction.
DESIGN
A cross-sectional national survey was conducted in 2018.
SETTING
Hospitals in 27 provinces and 4 municipalities in 4 regions of China.
PARTICIPANTS
A random sample of 15 699 patients who visited 1304 hospitals were surveyed, with around 500 from each of the 27 provinces and 4 municipalities.
PRIMARY AND SECONDARY OUTCOME MEASURES
The Hospital Consumer Assessment of Healthcare Providers and Systems questionnaire was used to measure patients' overall satisfaction and willingness to recommend the hospital.
RESULTS
We found significant variation in overall patient satisfaction but little variation in hospital recommendation across the four broad regions. Moreover, we examined determinants of patient satisfaction and their likelihood to recommend the hospital. The overall satisfaction for inpatients and outpatients is commonly influenced by communication with doctors (inpatient: β=0.524, p<0.001; outpatient: β=0.541, p<0.001), hospital cleanness (inpatient: β=0.165, p<0.05; outpatient: β=0.144, p<0.001) and acceptable charges (inpatient: β=1.481, p<0.001; outpatient: β=1.045, p<0.001). Both inpatients and outpatients are more likely to recommend the hospital if there are communication with doctors (inpatient: OR=1.743, p<0.001; outpatient: OR=1.647, p<0.001), acceptable charges (inpatient: OR=2.660, p<0.001; outpatient: OR=2.433, p<0.001). Outpatient satisfaction and hospital recommendation are also influenced by time spent with doctors (satisfaction: β=0.301, p<0.001; recommend: OR=1.430, p<0.001) and waiting time (satisfaction: β=-0.318, p<0.001; recommend: OR=0.844, p<0.001).
CONCLUSIONS
There are regional differences of patient satisfaction in China. Patient satisfaction is influenced by a variety of hospital factors and province/municipality factors. The influencing factors of patient satisfaction may not motivate patients to recommend the hospital.
Topics: China; Cross-Sectional Studies; Humans; Inpatients; Outpatients; Patient Satisfaction; Surveys and Questionnaires
PubMed: 34493518
DOI: 10.1136/bmjopen-2021-049570 -
PloS One 2019To understand how different methodologies of qualitative research are able to capture patient experience of the hospital journey.
PURPOSE
To understand how different methodologies of qualitative research are able to capture patient experience of the hospital journey.
METHODS
A qualitative study of orthopaedic patients admitted for hip and knee replacement surgery in a 250-bed university hospital was performed. Eight patients were shadowed from the time they entered the hospital to the time of transfer to rehabilitation. Four patients and sixteen professionals, including orthopaedists, head nurses, nurses and administrative staff, were interviewed.
RESULTS
Through analysis of the data collected four main themes emerged: the information gap; the covering patient-professionals relationship; the effectiveness of family closeness; and the micro-integration of hospital services. The three different standpoints (patient shadowing, health professionals' interviews and patients' interviews) allowed different issues to be captured in the various phases of the journey.
CONCLUSIONS
Hospitals can significantly improve the quality of the service provided by exploring and understanding the individual patient journey. When dealing with a key cross-functional business process, the time-space dynamics of the activities performed have to be considered. Further research in the academic field can explore practical, methodological and ethical challenges more deeply in capturing the whole patient journey experience by using multiple methods and integrated tools.
Topics: Aged; Attitude to Health; Female; Hospital-Patient Relations; Hospitalization; Humans; Male; Middle Aged; Patient Care; Patients; Quality of Health Care
PubMed: 31805061
DOI: 10.1371/journal.pone.0224899 -
CMAJ : Canadian Medical Association... Aug 2021
Topics: Humans; Patients; Publishing
PubMed: 34344781
DOI: 10.1503/cmaj.211092-f -
Academic Medicine : Journal of the... Feb 2022
Topics: Communication; Language; Medicine; Patients
PubMed: 34732652
DOI: 10.1097/ACM.0000000000004502 -
Applied Clinical Informatics Mar 2023The patient's voice, which we define as the words the patient uses found in notes and messages and other sources, and their preferences for care and its outcomes, is too...
The patient's voice, which we define as the words the patient uses found in notes and messages and other sources, and their preferences for care and its outcomes, is too small a part of the electronic health record (EHR). To address this shortcoming will require innovation, research, funding, perhaps architectural changes to commercial EHRs, and that we address barriers that have resulted in this state, including clinician burden and financial drivers for care. Advantages to greater patient voice may accrue to many groups of EHR users and to patients themselves. For clinicians, the patient's voice, including symptoms, is invaluable in identifying new serious illness that cannot be detected by screening tests, and as an aid to accurate diagnosis. Informaticians benefit from greater patient voice in the EHR because it provides clues not found elsewhere that aid diagnostic decision support, predictive analytics, and machine learning. Patients benefit when their treatment priorities and care outcomes considered in treatment decisions. What patient voice there is in the EHR today can be found in locations not usually used by researchers. Increasing the patient voice needs be accomplished in equitable ways available to people with less access to technology and whose primary language is not well supported by EHR tools and portals. Use of direct quotations, while carrying potential for harm, permits the voice to be recorded unfiltered. If you are a researcher or innovator, collaborate with patient groups and clinicians to create new ways to capture the patient voice, and to leverage it for good.
Topics: Humans; Electronic Health Records; Patients
PubMed: 36990457
DOI: 10.1055/s-0043-1767685 -
Revue Medicale Suisse Mar 2020
Topics: Humans; Life Style; Patients
PubMed: 32134220
DOI: No ID Found -
Revue Medicale Suisse Feb 2023Uncertainty is omnipresent in medical practice. It occurs when the available data do not allow predicting with accuracy the patient's outcome. Paradoxically, despite the... (Review)
Review
Uncertainty is omnipresent in medical practice. It occurs when the available data do not allow predicting with accuracy the patient's outcome. Paradoxically, despite the exponential progress of medical knowledge, uncertainty in medical practice seems to increase. Even though uncertainty is present at every stage of medical practice, this uncertainty is rarely discussed with the patient. However, there is an ethical and legal necessity to communicate it with the patient. The aim of this review is to describe the barriers and impacts of the communication of uncertainty with the patient and suggest strategies to enhance its communication.
Topics: Humans; Uncertainty; Communication; Patients
PubMed: 36753341
DOI: 10.53738/REVMED.2023.19.813.258