نوع مقاله : مقاله پژوهشی
نویسندگان
- مرجان وجدانی 1
- مریم گودرزیان 1
- زهرا رحیمی 2
- سید احسان صفاری 3
- مرضیه وجدانی 4
- سمیرا فوجی 5
- عارفه پورطالب 6
1 مربی، مرکز تحقیقات سلامت سالمندان، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.
2 کارشناس، گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.
3 متخصص آمار، گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.
4 کارشناس، گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.
5 مربی، گروه اتاق عمل، دانشکده پیراپزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.
6 دانشجوی دکتری، مرکز تحقیقات علوم مدیریت و اقتصاد سلامت، دانشکده مدیریت و اطلاع‌رسانی پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.
چکیده
اهداف توجه به جنبه‌های غیرپزشکی در مراقبت سلامت یا پاسخگویی بیانگر چگونگی تجربه بیمار از خدماتی است که در طول دوره مراقبت دریافت می‌کند. این موضوع بارها مورد تأکید سازمان بهداشت جهانی بوده است. این پژوهش با هدف ارزیابی وضعیت پاسخگویی از دیدگاه بیماران بستری در بیمارستان منتخب دانشگاه علوم پزشکی شهرستان سبزوار است.
مواد و روش ها در این مطالعه توصیفی و مقطعی جامعه پژوهش شامل تمام بیماران بستری‌شده در مرکز آموزشی، درمانی و پژوهشی واسعی سبزوار در سال 1394 است. 189 بیمار به روش طبقه‌ای دومرحله‌ای و تصادفی ساده از این مرکز آموزشی، درمانی و پژوهشی انتخاب شدند. ابزار گردآوری داده ها پرسش‌نامه استاندارد پاسخگویی بوده است. داده‌های پژوهش با استفاده از آمار توصیفی و آزمون‌های آماری تی و آنوا با نسخه 16 نرم‌افزار SPSS در سطح معناداری 0/05 تحلیل شد.
یافته ها یافته‌ها نشان داد از بین مؤلفه‌های هشت‌گانه پاسخگویی، دسترسی به حمایت‌های اجتماعی در دوره بستری بیشترین نمره و استقلال بیمار کمترین نمره را به خود اختصاص داده است. بین دسترسی به حمایت‌های اجتماعی و جنسیت رابطه معنادار وجود داشت (50/0≥P). همچنین بین بخش بستری‌شده بیماران با دسترسی به حمایت‌های اجتماعی در دوره بستری و کیفیت امکانات رفاهی رابطه معنادارمشاهده شد (50/0≥P). از دیدگاه بیماران میانگین نمره کل پاسخگویی در بیمارستان مطالعه‌شده از حداکثر چهار نمره (60/0±43/2) به دست آمد که نمایانگر پاسخگویی در حد متوسط است.
کلیدواژه‌ها
عنوان مقاله [English]
Responsiveness in Health Service: Patients Experience in Hospital of Sabzevar
نویسندگان [English]
- Marjan Vejdani 1
- Maryam Godarzeyan 1
- Zahra Rahimi 2
- Seyyed Ehsan Saffari 3
- Marzieh Vejdani 4
- Samira Fouji 5
- Arefeh Pourtaleb 6
1 Instructor, Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran.
2 BSc., Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.
3 Statistics Specialist, Department of Epidemiology and Biostatics, School Of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
4 BSc., Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.
5 Instructor, Department of Operating Room, Faculty of Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran.
6 PhD. Candidate, Health Management and Economics Research Center, Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]
Background Considering patient’s experiences about non clinical aspect of health care services is now seen as a key characteristic of an effective health system. This study looks into the Responsiveness in Sabzevar University of Medical Sciences, 2015.
Methods & Materials In this cross-sectional and explanatory study, 189 hospitalized patients in Vasai hospital were selected using a stratified and simple random sampling. Standard Responsiveness Questionnaire was used as the data collection tool. Data were analyzed using descriptive statistics, independent t-tests and ANOVA by SPSS 16 at a significance level of 0.05.
Results Access to the social support during hospitalization achieved the highest score while patient autonomy received the least score. There was a significant relationship between Access to the social support and patient’ gender (P≤0.05). Results showed significant differences between wards in this hospital and Access to the social support and Quality of basic amenities (P≤0.05). From patient view point the total score for this hospital was (2.43±0.60) that showed the moderate level of responsiveness.
Conclusion More than ever trying to institutionalize the principle of responsiveness culture in this kind of training educational hospital should be regarded. In this way it could be helpful to design a new scientific approach to implement and evaluate responsiveness in hospital regularly. It also would be an effective way to design suitable guideline and checklist along with improve clinical governance and clinical audit
کلیدواژه‌ها [English]
- responsiveness
- Hospital
- Patient
Thomas LH, Bond S. Measuring patients’ satisfaction with nursing: 1990-1994. Journal of Advanced Nursing. 1996; 23(4):747-56. doi: 10.1111/j.1365-2648.1996.tb00047.x
Ware J. What information do consumers want and how will they use it? Medical Care . 1995; 33:25-30. doi: 10.1097/00005650-199501001-00005
Coulter A, Jenkinson C. European patients’ views on the responsiveness of health systems and healthcare providers. The European Journal of Public Health. 2005; 15(4):355-60. doi: 10.1093/eurpub/cki004
Hsu CC, Chen L, Hu YW, Yip W, Shu CC. The dimensions of responsiveness of a health system: a Taiwanese perspective. BMC Public health. 2006; 6:72. doi: 10.1186/1471-2458-6-72
Rice N, Robone S, Smith PC. The measurement and comparison of health system responsiveness. York: University of York; 2008.
Rashidian A, Kavosi Z, Majdzadeh R, AGh P, Pourmalek F, Arab M, Mohammad K. Assessing health system responsiveness: a household survey in 17th District of Tehran. Iranian Red Crescent Medical Journal. 2011; 13(5):302-8. PMCID: PMC3371967
Valentine N, Darby C, Bonsel GJ. Which aspects of non-clinical quality of care are most important? Results from WHO’s general population surveys of “health systems responsiveness” in 41 countries. Social Science & Medicine. 2008; 66(9):1939-50. doi: 10.1016/j.socscimed.2007.12.002
Karami Tanha F, Fallah Abadi H. Health system responsiveness for care of patients with heart failure: evidence form a university hospital. Archives of Iranian Medicine. 2014; 17(11):736-40. doi: 0141711/AIM.003
Naseer M, Zahidie A, Shaikh BT. Determinants of patient's satisfaction with health care system in Pakistan: A critical review. Pakistan Journal of Public Health. 2012; 2(2):52.
Kowal P, Naidoo N, Williams SR. Performance of the health system in China and Asia as measured by responsiveness. Health. 2011; 3(10):638-46. doi: 10.4236/health.2011.310108
Liabsuetrakul T, Petmanee P, Sanguanchua S, Oumudee N. Health system responsiveness for delivery care in Southern Thailand. International Journal for Quality in Health Care. 2012; 24(2):169-75. doi: 10.1093/intqhc/mzr085
Darby C, Valentine N, Murray CJ, De Silva A. World Health Organization: strategy on measuring responsiveness. Geneva: World Health Organization; 2000.
Hodge, JG, Gostin, LO, Valentine N, Nygren Krug H. The domains of health responsiveness: a human rights analysis. Geneva: World Health Organization; 2003.
World Health Organization. The world health report 2000: health systems: improving performance. Geneva: World Health Organization; 2000.
Ministry of Health. [Third and fourth development plans (Persian)] [Internet]. 2010 [Cited 2010 Apr. 4]. Available from: http://www.irannsr.org/services/nsr_Rules/1743
Javadi M, Karimi S, Raiesi A, Yaghoubi M, Kaveh K. Comparison of patients’ and nurses’ viewpoints about responsiveness among a sample from public and private hospitals of Isfahan. Iranian Journal of Nursing and Midwifery Research. 2011; 16(4):273-7. PMCID: PMC3583095
Valentine NB, De Silva A, Kawabata K, Darby C, Murray CJ, Evans DB, et al. Health system responsiveness: concepts, domains and operationalization. In: Murray CJL, Evans DB. Health Systems Performance Assessment: Debates, Methods and Empiricism. Geneva: World Health Organization; 2003.
Peltzer K. Patient experiences and health system responsiveness in South Africa. BMC Health Services Research. 2009; 9:117. doi: 10.1186/1472-6963-9-117
Ebrahimipour H, Najjar AV, Jahani AK, Pourtaleb A, Javadi M, Rezazadeh A, et al. Health system responsiveness: a case study of general hospitals in Iran. InternationalJournal of Health Policy & Management. 2013; 1(1):85-90. doi: 10.15171/ijhpm.2013.13
Habibullah S. Responsiveness of the federal health system to the needs of 18-45 year old adults with physical disabilities in Islamabad, Pakistan [PhD thesis]. South Florida: University of South Florida.
Ristea AL, Ioan Franc V, Dinu V. Responsiveness of health systems: a barometer of the quality of health services. Amfiteatru Economic. 2009; 11(26):277-87.
Arab M, Pourreza A, Eshraghian M, Khabiri R. [A survey on current status of patient information privacy in Tehran’s hospitals (Persian)]. Health Information Management. 2010; 8(1):33-40.
Parsa M. [Privacy and confidentiality in medical and it’s various aspects (Persian)]. Iranian Journal of Medical Ethics and History of Medicine. 2009; 2(4):1-14.
Matiti MR, Trorey GM. Patients’ expectations of the maintenance of their dignity. Journal of Clinical Nursing. 2008; 17(20):2709-17. doi: 10.1111/j.1365-2702.2008.02365.x
Whitehead J, Wheeler H. Patients’ experiences of privacy and dignity. Part 1: A literature review. British Journal of Nursing. 2008; 17(6):381-5. doi: 10.12968/bjon.2008.17.6.28904
Lin YP, Tsai YF, ChenHF. Dignity in care in the hospital setting from patients’ perspectives in Taiwan: a descriptive qualitative study. Journal of Clinical Nursing. 2011; 20(5-6):794-801. doi: 10.1111/j.1365-2702.2010.03499.x
Fotaki M, Roland M, Boyd A, Mc Donald R, Scheaff R, Smith L. What benefits will choice bring to patients? Literature review and assessment of implications. Journal of Health Services Research & Policy. 2008; 13(3):178-84. doi: 10.1258/jhsrp.2008.007163
Dickert NW, Kass NE. Understanding respect: learning from patients. Journal of Medical Ethics. 2009; 35(7):419-23. doi: 10.1136/jme.2008.027235
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