医患协同视角下加速康复外科实施影响因素分析

Doctor-patient Collaborative Perspective to Enhance Recovery after Surgery to Implement the Influence Factors of Investigation

目的了解四川省三级甲等综合公立医院实施加速康复外科(Enhanced Recovery after Surgery,ERAS)的影响因素。方法采用方便抽样和偶遇抽样的方法,结合SPO理论,自行设计调查问卷。选取四川省11家三级甲等综合公立医院为研究对象,收集并分析其普通外科正在开展ERAS的医务人员和患者的资料。结果共纳入606名医务人员和443名患者。logistic多元回归分析结果显示,医患协同重要性的认知程度、人力资源、领导负责制、多学科协作是影响加速康复外科实施的主要因素。多重响应分析结果显示,患者对ERAS实施的期望更倾向于医务人员人力资源(41.8%)、医患沟通(12.3%)及科室协作(9.7%)。结论从影响因素来看,医疗机构管理者可以将重点放在医患协同概念认知和培训、人力资源的配备、院级领导负责项目开展、多学科协作及有效医患沟通上,协同布局医疗资源,以促进加速康复在临床的实施和推广。

Objective Understand the influence factors of the grade A tertiary general public hospitals in Sichuan province implemented Enhanced Recovery after Surgery(ERAS).Methods With the method of convenient sampling and encounter sample,combined with SPO theory,designed for the questionnaire.Eleven tertiary general public hospitals in Sichuan Province were selected for the study to collect and analyse data from medical staff and patients in their general surgery departments who were carrying out ERAS.Results Participants included 606 staff and 443 pa⁃tients.Logistic multiple regression analysis shows that the importance of doctor-patient collaboration cognitive de⁃gree,human resources,leadership responsibility system,the multidisciplinary collaboration is the main factors influ⁃encing the accelerate rehabilitation surgery to implement.Multiple response analysis showed that patients with the expectation of the implementation of ERAS tend to medical personnel of human resources(41.8%),doctor-patient communication(12.3%)and department cooperation(9.7%).Conclusion From the factors influencing the level,managers of medical institutions can be management focuses on the concept of doctor-patient collaboration cogni⁃tive and training,human resources,equipment,hospital leaders responsible for the project and the multidisciplinary collaboration,cooperative medical resource layout,so as to promote accelerated rehabilitation in clinical implementa⁃tion and promotion.