三级电话回访对糖尿病出院患者满意度及血糖控制的影响

发布时间：2018-02-02 09:33

本文关键词： 三级电话回访糖尿病满意度血糖影响　出处：《河北医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过对糖尿病出院患者开展“三级电话回访”,观察对患者满意度和血糖控制的干预效果。在满意度对比分析中,发现医院整体医疗技术、服务水平、预防保健、内部流程等方面的薄弱环节,为提升患者满意度,加强医院管理,改进医疗服务,培养医院忠诚病人群体提供新的管理方法。方法:在参考国内外文献和做法的基础上,采取完全随机抽样方法,抽取沧州某医院糖尿病科2015年5月份200名出院患者,随机设置实验组(n=100)和对照组(n=100),实验组接受三级电话回访,即一级电话回访:结合出院患者病情,由主管医生给予电话回访指导;二级电话回访:由医院随访中心对患者病情以外的服务、费用、流程、管理、医德医风等情况予以电话回访;三级电话回访:由医院健康教育科为出院患者免费建档开展疾病随访和疾病管理。对照组不予三级电话回访。利用已开展信度和效度检验的《出院患者满意度评价指标体系》对实验组对照组进行问卷调查和资料收集,对问卷结果采用SPSS 19.0统计学软件进行t检验、X2检验、Mann-Whitney Test等,观察实验组和对照组满意度差别及出院患者12个月复查血糖指标。同时对电话回访征询的意见建议进行分析,提出整改措施。结果:实验组较对照组满意度差异有显著性意义(P0.05),整体上实验组满意度88.1%,对照组满意度84.78%;各二级指标满意度差异均有显著性意义(P0.05),其中,诊疗环境满意度(实验组81%,对照组77.3%),诊疗流程满意度(实验组88.22%,对照组84.88%),服务态度满意度(实验组87.96%,对照组84.36%),医疗费用满意度(实验组为88.28%,对照组为83.02%),医德医风满意度(实验组为93.02%,对照组为91.58%),诊疗技术满意度(实验组为91.88%,对照组为89.26%)。同时得出影响医院患者满意度的关键因素,如疗效、时间、交通、费用、流程、医德医风、住院环境、卫生等综合因素,医院管理者可针对性对这些领域进行改进提高,从而改进医疗服务。患者出院12个月复查值,实验组较对照组空腹血糖、餐后2小时血糖指标差异有显著性意义(P0.05)。结论:在糖尿病出院患者中进行“三级电话回访”,可有效提升患者满意度,将疾病管理引入第三级回访,可增强患者依从性和疾病自我管理能力,干预对患者血糖控制起到了一定的作用,部分改善出院患者愈后各项指标。三级电话回访,作为一项提高患者满意度,改进医疗服务的措施,具有很强的推广意义。
[Abstract]:Objective: to observe the effect of intervention on patients' satisfaction and blood sugar control by "three-level telephone return visit" to patients with diabetes mellitus discharged from hospital. In the comparative analysis of satisfaction, we found the overall medical technology and service level of the hospital. In order to improve patients' satisfaction, strengthen hospital management and improve medical services, preventive health care, internal processes and other weak links. Methods: on the basis of reference of literature and practice at home and abroad, complete random sampling was adopted. In May 2015, 200 patients were selected from the Diabetes Department of Cangzhou Hospital. The experimental group and control group were randomly divided into two groups: the experimental group and the control group. The experimental group received a telephone call back to the third class. That is, a telephone return visit: combined with discharged patients, by the competent doctor to give telephone return visit guidance; Second-level telephone return visit: the hospital follow-up center for patients beyond the condition of the service, fees, processes, management, medical ethics and so on to call back; III telephone return visit:. The health education department of the hospital carried out the disease follow-up and disease management for discharged patients free of charge. The control group did not return to the third grade telephone. The evaluation index system of the satisfaction degree of discharged patients was used to evaluate the reliability and validity of the system. The control group was investigated by questionnaire and data collection. The results of the questionnaire were analyzed by SPSS 19.0 software. T test and X 2 test were used to test Mann-Whitney Test and so on. To observe the difference of satisfaction between the experimental group and the control group, and to review the blood glucose index of the discharged patients at 12 months. At the same time, to analyze the opinions and suggestions of the telephone return visit. Results: compared with the control group, the satisfaction degree of the experimental group was significantly higher than that of the control group (P 0.05). The overall satisfaction of the experimental group was 88.1m, and that of the control group was 84.78g; There was significant difference in the satisfaction degree between the two indexes (P 0.05). Among them, the satisfaction degree of diagnosis and treatment environment (the experimental group 81, the control group 77.3). The satisfaction of the diagnosis and treatment process was 88.22 in the experimental group, 84.88 in the control group, and in the service attitude (87.96 in the experimental group and 84.36in the control group). The satisfaction degree of medical expenses was 88.28 in the experimental group, 83.02 in the control group and 93.02 in the experimental group and 91.58 in the control group. The satisfaction degree of diagnosis and treatment technology was 91.88 in the experimental group and 89.26 in the control group. At the same time, the key factors affecting the patient satisfaction were obtained, such as curative effect, time, transportation, cost and flow. Medical ethics, hospital environment, health and other comprehensive factors, hospital managers can be targeted to improve these areas, thereby improving medical services. Patients discharged from hospital 12 months review value. Compared with the control group, the fasting blood glucose and 2 hours postprandial blood glucose in the experimental group were significantly different (P 0.05). Conclusion: in the patients with diabetes mellitus discharged from hospital, the "three level telephone return visit" was carried out. It can effectively improve patients' satisfaction, introduce disease management into the third level of return visits, can enhance patients' compliance and disease self-management ability, and intervention plays a certain role in the control of patients' blood sugar. As a measure to improve patients' satisfaction and improve medical service, it is of great significance to popularize the three-level telephone return visit.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.5

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