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Erhebung der Patientenzufriedenheit in der Geriatrie

Eine methodologische Pilotstudie

Assessment of patient satisfaction in geriatric hospitals: a methodological pilot study

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Zusammenfassung

Die Erhebung von Patientenurteilen in der Akutmedizin ist ein Bestandteil der Qualitätssicherung im Gesundheitswesen. Die Bedürfnisse betagter Patienten und die interprofessionelle Vorgehensweise der Geriatrie wurden bei solchen Erhebungen kaum berücksichtigt. In der vorliegenden Arbeit überprüften wir eine für die Geriatrie entwickelte Befragung zur Erfassung der Zufriedenheit bei 1918 Patienten im Alter von 82 Jahren (Median, M) mit einem Minimental-Score (MMS) von 25 Punkten (M) in drei Schweizer Geriatriekliniken auf Akzeptanz, Durchführbarkeit und Eignung. Alle verwertbaren schriftlichen Antworten wurden auf psychometrischen Eigenschaften überprüft. Parallel dazu erfragten wir die Zufriedenheit von Familienangehörigen. Die Rücklaufquote bei den Patienten betrug 32% (Fragebogen) beziehungsweise 60% (Interviews) und war bei Fragebogen abhängig vom MMS. Die Rücklaufquote bei den Familienangehörigen betrug 35%. Das theoretische Konstrukt Patientenzufriedenheit in der Geriatrie erwies sich in vielen Domänen als reliabel und valide. Die Cronbach-Alpha Werte für unterschiedliche Bereiche lagen zwischen minimal 0,67 (Hotellerie, Zimmer) und 0,92 (Ärzte). Problematisch waren die Bereiche Qualität der therapeutischen Behandlung und Qualität der Schmerzbehandlung. Die Patienten waren mit den Dienstleistungen der teilnehmenden Geriatrien zufrieden. Angehörige hingegen kritisierten den Informationsfluss zwischen den medizinischen Diensten und den Angehörigen.

Das vorliegende Instrument ist gut in geriatrischen Kliniken einsetzbar und kann wertvolle Informationen für die Optimierung der Qualität der verschiedenen Dienstleistungen in den Bereichen Pflege, ärztliche Betreuung und Hotellerie einer geriatrischen Institution liefern.

Abstract

The assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We exam ined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patient’s spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%.

The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses.

Conclusions

An instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.

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Correspondence to Thomas Münzer.

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Huber, J.P., Saldutto, B., Hürny, C. et al. Erhebung der Patientenzufriedenheit in der Geriatrie. Z Gerontol Geriat 41, 124–131 (2008). https://doi.org/10.1007/s00391-007-0454-2

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  • DOI: https://doi.org/10.1007/s00391-007-0454-2

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