Patients’ Perceptions and Expectations of Family Participation in the Informed Consent Process of Elective Surgery in Taiwan

Mei-Ling Lin,Wai-Ming Kan,Ching-Huey Chen 한국간호과학회 2012 Asian Nursing Research Vol.6 No.2

Purpose: This study investigated patients’ perceptions and expectations of their families’ participation in the informed consent process of elective surgery. Methods: This is a survey study. Anonymous questionnaires that were mailed to potential participants included a demographic data sheet and a scale, measuring patients’ perceptions of themselves and their families’ participation level in the informed consent process. A convenience sample of patients who had undergone surgery and had been discharged within 4 months from a medical center in southern Taiwan (n ¼ 1,737) were recruited. Results: One hundred and forty-five recipients replied, gaining a response rate of 10.0%, and 120 provided complete data. The mean age of the participants was 56.0 years (range 20e85, SD ¼ 14.98), and more than half were female (54.2%). Twenty-one participants (17.5%) perceived having less family participation than their own participation in the surgery informed consent process, and 40% expected more family participation in the process. The mean scores of the self-rated participation level was significantly higher than that of the families (p < .001). Patients' expectations of family participation were significantly higher than their perceptions of family participation (p < .001). Eleven patients (9.2%) reported having more family participation than they expected. Participants received the most information about the disease during the informed consent process and the least information about alternatives to surgery. Age,gender, number of previous surgeries and admissions influenced the study participants' perceived level of participation in the informed consent process. Conclusion: This preliminary study demonstrates that patients’ perceptions and expectations for family participation in the surgical informed consent process vary. Healthcare providers should be aware of patients’ expectation to appropriately invite their family into the informed consent process. Purpose: This study investigated patients’ perceptions and expectations of their families’ participation in the informed consent process of elective surgery. Methods: This is a survey study. Anonymous questionnaires that were mailed to potential participants included a demographic data sheet and a scale, measuring patients’ perceptions of themselves and their families’ participation level in the informed consent process. A convenience sample of patients who had undergone surgery and had been discharged within 4 months from a medical center in southern Taiwan (n ¼ 1,737) were recruited. Results: One hundred and forty-five recipients replied, gaining a response rate of 10.0%, and 120 provided complete data. The mean age of the participants was 56.0 years (range 20e85, SD ¼ 14.98), and more than half were female (54.2%). Twenty-one participants (17.5%) perceived having less family participation than their own participation in the surgery informed consent process, and 40% expected more family participation in the process. The mean scores of the self-rated participation level was significantly higher than that of the families (p < .001). Patients' expectations of family participation were significantly higher than their perceptions of family participation (p < .001). Eleven patients (9.2%) reported having more family participation than they expected. Participants received the most information about the disease during the informed consent process and the least information about alternatives to surgery. Age,gender, number of previous surgeries and admissions influenced the study participants' perceived level of participation in the informed consent process. Conclusion: This preliminary study demonstrates that patients’ perceptions and expectations for family participation in the surgical informed consent process vary. Healthcare providers should be aware of patients’ expectation to appropriately invite their family into the informed consent process.

Patient Participation in Patient Safety and Its Relationships with Nurses' Patient-Centered Care Competency, Teamwork, and Safety Climate

황지인,김성완,진호준 한국간호과학회 2019 Asian Nursing Research Vol.13 No.2

Purpose: This study's aim was to examine degrees of patient participation in patient safety activities in hospitals and to investigate their relationships with nurses' patient-centered care competency (PCC), teamwork, and safety climate. Methods: A cross-sectional study designwas used. Data were collected with 479 nurses from two general hospitals in Seoul, Korea, using a questionnaire designed to collect data on patient participation in patient safety activities, PCC, teamwork perceptions, and safety climate. The response rate was 74.1% (N = 355). Data were analyzed using descriptive statistics and multiple logistic regression analysis. Results: The mean score for patient participation was 2.76 ± 0.46 of 4.0. The mean scores for PCC, teamwork, and safety climate were 3.61 ± 0.46, 3.64 ± 0.41, and 3.35 ± 0.57 of 5.0, respectively. Nurses who experienced high patient participation in patient safety activities ( 3.0) had higher scores for PCC, teamwork, and safety climate. Multiple logistic regression analysis revealed that PCC (OR = 2.31, 95% CI = 1.14e4.70) and safety climate (OR = 2.51, 95% CI = 1.09e5.78) scores were the significant factors associated with patient participation. Conclusion: The degree of patient participation in patient safety activities was not high. Nurses' PCC, teamwork, and safety climate were positively related with patient participation. In particular, the findings indicate that enhancing nurses' competency for patient-centered care and creating a strong safety climate are important to promote patient participation for safer health care.

혈액종양내과 환자의 환자안전인식과 환자참여

강세정,박정윤 대한종양간호학회 2019 Asian Oncology Nursing Vol.19 No.4

Purpose: This study was to investigate patient safety perception and patient participation, and to provide basic data for the development of patient participation education programs. Methods: The subjects of this study were 183 patients with at least one experience of the Hemato-oncology Department at a tertiary hospital in Seoul. Data were collected from April 11, 2019 to May 7, 2019 using structured questionnaires including patient safety perception and patient participation. Results: The patient safety perception score was 4.23±0.48 out of 5. The patient participation score was 4.30±0.53 out of 5. Patient safety perception was significantly different according to age (p=.008), education (p=.045), employment status (p=.031), marital state (p=.037), medical department (p=.004), comorbidity (p=.046), and patient participation education (p=.010). Patient participation was significantly difference in age (p=.020), education (p=.004) and employment status (p=.005). The correlation between the patient safety perception and patient participation was statistically significant (r=.75, p<.001). Conclusion: It is necessary to improve the system for medical staff, patients and medical institutions in order to enable patients to communicate with medical staff in a satisfactory manner and participate in patient safety activities.

군병원 환자참여교육이 환자안전인식, 환자참여, 의료진과의 관계에 미치는 효과

조순영,우선영,김지혜 국군간호사관학교 군건강정책연구소 2022 군진간호연구 Vol.40 No.2

Purpose: The purpose of this study is to assess the effects of patient participation education on the patient safety perception, patient participation, and patient-provider relationship in ROK Military Hospital. Methods: A non-equivalent control group pretest-posttest design was used for the study. Participants were 135 inpatients (control group: 71; experimental group: 64). Patient participation education was provided both offline and online using picture cards and videos. This study was conducted in a military hospital from 27 May to 31 August 2021. Data were analyzed by the chi-square test, independent t-test, paired t-test, and Analysis of Covariance (ANCOVA) using SPSS program. Results: The results revealed that there was a statistically significant difference in patient safety perception (F=16.33, p<.001) and patient participation(F=17.14, p<.001) scores between the control and experimental groups. In addition, the degree of increase in patient safety perception and patient participation scores in the experimental group was significantly higher than those of the control group (t=-3.63, p<.001; t=-3.40, p<.001). However, there was no statistically significant difference in patient-provider relationship score between the control and experimental groups. Conclusion: Patient participation education can improve patient safety perception and patient participation, which are necessary to prevent patient safety incidents and improve the quality of care. We suggest to develop systematic and standardized patient participation education in various ways.

의사의 환자중심 커뮤니케이션이 환자참여에 미치는 영향

이종학(Jong-Hak Lee),김찬중(Chan-Jung Kim) 한국콘텐츠학회 2013 한국콘텐츠학회논문지 Vol.13 No.3

본 연구는 의사의 환자중심 커뮤니케이션(촉진요인, 금지요인)이 환자 참여(행동적 참여, 감정적 참여, 정보적 참여)에 미치는 영향을 분석하기 위한 것이다. 구체적인 연구목적으로는 첫째, 환자중심 커뮤니케이션이 환자참여에 미치는 영향, 둘째, 환자중심의 커뮤니케이션과 환자참여간의 관계에서 신뢰의 조절효과 확인이며, 이를 위하여 국내 종합병원의 환자 301명을 대상으로 SPSS 19.0을 통계패키지를 사용하여 요인분석과 조절회귀분석을 수행하였다. 연구결과, 커뮤니케이션 촉진요인은 행동적 참여, 감정적 참여, 정보적 참여 모두에 유의한 정(+)의 영향을 미치는 것으로 확인되었으나, 금지요인은 영향을 미치지 않는 것으로 나타났다. 또한 신뢰의 조절효과는 촉진요인과 감정적 참여간, 촉진요인과 정보적 참여간에서 발견되었으며, 신뢰의 수준이 높은 집단에서 촉진요인은 감정적 참여와 정보적 참여에 더 큰 영향을 미치는 것으로 확인되었다. 마지막으로 이러한 연구결과를 토대로 환자중심의 커뮤니케이션과 성공적인 의료서비스 제공에 필요한 이론적이고 실무적인 시사점을 제공하였다. The main purpose of this study is to examine the effect of patient-centered communication of doctor(facilitating factor, inhibition factor) on patient participation(behavioral participation, emotional participation, informational participation). Concretely, it is confirmed where there are effects of patient-centered communication of doctor to patient participation and whether there are moderating effects of trust between patient-centered communication of doctor and patient participation. In domestic general hospital, 301 samples were for this analysis collected and tested by factor analysis and moderating regression analysis. As a result of this study is as followings. First, it is confirmed that communication facilitating factor have influences on patient participation positively and communication inhibition factor have no influences on patient participation. Second, there are moderating effects of trust between facilitating factor and emotional participation, between facilitating factor and informational participation. Especially, in higher level group of trust, it is confirmed that facilitating factor more influence on emotional participation and informational participation. On the basis of these study results, I suggested theoretical and practical implication for the patient-centered communication and successful medical service.

외래 의료서비스 이용 환자의 환자참여 경험이 환자만족에 미치는 영향

안신애 간호행정학회 2022 간호행정학회지 Vol.28 No.2

Purpose: This study examined outpatients’ experiences of patient participation, their level of patient satisfaction, and the factors that influence their patient satisfaction with outpatient care. Methods: This cross-sectional descriptive study utilized secondary data from the 2018 Survey on the Experience with Healthcare Service conducted in South Korea. Data from 6,684 outpatients over the age of 20 years who had visited hospitals were analyzed. Patient characteristics, health-related characteristics, and their experiences of patient participation were assessed as factors related to patient satisfaction. Factors that influenced patient satisfaction with outpatient care were identified using logistic regression analysis. Results: Overall, 84.9% of the participants were satisfied with the received outpatient care. Higher patient satisfaction with outpatient care was significantly associated with middle (40-59 years) and old age (≥60 years), good self-rated health status, and experience of patient participation in patient safety activities. Conclusion: Multiple factors were related to patient satisfaction with outpatient care. These factors need to be considered when evaluating patients’ satisfaction levels. To improve satisfaction with health care use, it is essential to provide more experiences and expand their opportunities for patient participation during the care process and establish healthcare policies and strategies to enhance patient participation in patient safety. 연구목적: 본 연구의 목적은 환자가 경험한 외래 의료서비스 이용 과정에서의 환자참여 경험 정도와 환자만족 현황을 파악하고 환자만족에 영향을 미치는 요인을 파악하기 위함이다. 연구방법: 본 연구는 ‘2018년 의료서비스경험조사’ 데이터를 사용하여 의원급과 병원급 의료기관의 외래 의료서비스 이용 경험이 있는 20세 이상의 성인 6,684명의 자료를 분석하였다. 환자만족에 영향을 미치는 요인은 환자 특성, 건강관련 특성, 환자참여 경험으로 분류하였으며 로지스틱 회귀분석을 통해 분석하였다. 연구결과: 대상자의 84.9%가 외래 의료서비스에 만족하는 것으로 나타났다. 외래 의료서비스를 이용하는 환자의 환자만족에는 연령, 주관적 건강수준, 환자참여 경험이 유의한 영향을 미치는 것으로 확인되었다. 결론: 환자만족에는 다양한 요인이 관련되어 있으며 이러한 요인을 고려하여 환자만족을 평가할 필요가 있다. 외래 의료서비스를 이용하는 환자의 만족을 높이려면 환자참여를 증진시키기 위한 의료정책 및 전략 수립을 통해 치료과정에서 환자가 참여할 수 있는 기회를 확대해 주는 것이 필요하다.

병원 진료에 대한 환자들의 참여 경험

정수진(Chung, Soojin),황지인(Hwang, Jee-In) 한국간호행정학회 2017 간호행정학회지 Vol.23 No.5

Purpose: The aim of this study was to explore patients’ experience of participation in their hospital care. Methods: Face-to-face interviews using a semi-structured interview guide were conducted with a total of 21 patients in a tertiary hospital in Seoul, South Korea. Collected data were analyzed using a qualitative content analysis. Results: Two categories of patients’ experience of participation in hospital care emerged: 1) Reactive participatory activity, 2) active participatory activity. Major participatory activities included ‘complying with medical instructions’, ‘listening’, ‘responding’ and ‘questioning’. Healthcare professionals’ attentive attitudes and explanation, and availability of care equipment were facilitating factors affecting patient participation in their care, whereas limited accessibility to and poor communication with healthcare professionals, inconvenient patient room, and patient factors were barriers to their participation. Conclusion: The findings in this study reveal that patients tend to participate in their care in a reactive way and that healthcare professionals have a significant role in facilitating patients’ participation. Furthermore, the care environment and patient factors need to be considered to promote patient participation in hospital care.

Influence of Nursing Manager's Ethical Leadership Perceived by Nurses in Patient-Engaged Nursing Services: Mediating Effect of Patient Participation Culture

윤예슬,지윤정,이태화 간호행정학회 2023 간호행정학회지 Vol.29 No.4

Purpose: This study investigated the mediating effect of patient participation culture in the relationship between ethical leadership and performance in patient-engaged nursing services. Methods: This study employed a cross-sectional descriptive online survey design. The sample comprised 104 nurses from small- and middle-sized Korean hospitals. Data were collected between May 10 and September 10, 2019 using the Smart Patient Engagement Assessment Checklist, Korean versions of the Patient Participation Culture Tool for healthcare workers, the Ethical Leadership Scale, and a questionnaire about nurses’ demographic and work characteristics. A mediation analysis was conducted using multiple regression and a simple model applying the PROCESS macro using SPSS Windows software version 26.0. Results: Ethical leadership directly affected (c’=0.28, p<.001) performance in patient-engaged nursing services. Patient participation culture partially mediated the relationship between ethical leadership and performance in patient-engaged nursing services (a․b=0.51 × 0.20=0.10, 95% Boot CI=0.18-0.20). Conclusions: Optimizing the patient participation culture and adherence to ethical leadership among hospital administrators and managers can improve nurses’ performance in patient-engaged nursing services. Nurse managers’ ethical leadership should be strengthened, and patient participation culture should be encouraged at policy levels through systematic nurse education on patient safety and engagement to enhance performance-engaged nursing services.

임상간호사의 환자중심간호역량과 안전문화풍토 및 직무만족이 환자참여에 미치는 영향

양경수(Kyeong Soo Yang),송미옥(Mi Ok Song) 한국산학기술학회 2023 한국산학기술학회논문지 Vol.24 No.9

환자참여는 간호의 질과 환자의 안전을 향상시키기 위한 필수적인 요소로 환자 참여를 위한 간호사의 노력은 중요하다. 본 연구는 임상간호사의 환자중심간호역량과 안전문화풍토 및 직무만족이 환자참여에 미치는 영향을 파악하기 위해 시행되었다. 환자참여에 영향을 미치는 요인을 조사하기 위해, (a) Person-Centered Nursing Competency Tool, (b) the Safety Climate Tool, (c) Job Satisfaction Tool 및 (d) Patient Participation Culture Tool for healthcare workers를 조사도구로 활용하였다. 자료 수집은 2022년 8월 10일부터 8월 24일까지 G광역시 5개 종합병원에 근무 중인 191명의 간호사를 대상으로 하였다. 설문 자료는 SPSS/WIN 26.0 프로그램을 이용하여 기술통계, 독립표본 t 검증, 일원분산분석, Scheffe 사후검증, Pearson 상관 관계 및 다중회귀분석으로 분석하였다. 본 연구결과, 환자참여에 영향을 미치는 요인은 환자중심간호역량(β=.30, p <.001), 안전문화풍토(β=.25, p =.001), 직무만족(β=.25, p <.001)이었으며, 이들 변수에의 설명력은 38.0%였다(F=39.77, p <.001). 본 연구 결과를 통해 임상간호사의 환차참여 수준을 높이기 위해 근무환경 개선, 적정 인력 배치, 환자중심간호에 대한 적절한 교육을 실시하고, 환자참여를 위한 표준화된 업무 지침 마련, 환자 조언기구 설치와 같은 정책적 지지 체계개발이 요구된다. Nurses efforts to improve patient participation are important as it is an essential factor in improving the quality of nursing and patient safety. This study investigates patient-centered nursing competency, safety climate, job satisfaction, and patient participation among clinical nurses. The tools used to investigate the factors affecting patient participation include (a) Person-Centered Nursing Competency tool, (b) Safety Climate Tool, (c) Job Satisfaction tool, and (d) Patient Participation Culture Tool for healthcare workers. The questionnaire survey was completed by 191 clinical nurses in 5 general hospitals in G metropolitan city from 10 August to 24 August 2022. The survey data was analyzed using descriptive statistics, t-test, ANOVA, Pearsons correlation coefficients, and multiple linear regression using the SPSS/WIN 26.0 program. The key factors influencing patient participation were identified as patient-centered nursing competency (β=0.30, p <0.001), safety climate (β=0.25, p =0.001), and job satisfaction (β=0.25, p <0.001). The explanatory power of these factors was 38.0%. Therefore, to improve patient participation by nurses, it is necessary to improve the working environment, ensure proper staffing, and conduct appropriate education. Furthermore, there is a need to develop policy support, such as preparing standardized guidelines for patient participation, and establishing a patient advisory body.

Thai Oncology Nurses' Perceptions of Patient Participation in Acute Cancer Care

Kanaungnit Pongthavornkamol,Aphorn Khamkon,Warunee Phligbua,Emma Cohen,Mari Botti 한국간호과학회 2018 Asian Nursing Research Vol.12 No.3

Purpose: Patient participation in care is considered a core component of high-quality nursing care and medical treatment. In the context of cancer care in Thailand, we know very little about the way patient participation in care is perceived and enacted. The aim of this study was to explore Thai oncology nurses' perceptions and understandings of patient participation in their own care during hospitalization. Methods: A qualitative descriptive research approach using focus groups was applied. Two focus group interviews (N = 16) were conducted with registered nurses who provide care in oncology units of one tertiary care university hospital in Bangkok, Thailand. The transcribed interviews were analyzed using qualitative content analysis. Results: In this study, nurses were aware of the value of patient participation during hospitalization but acknowledged that current processes to involve patients in their care were not as effective as they could be. Facilitating participation is seen as a means of supporting patients to make decisions independently that are in line with their treatment plans, in particular, decisions related to self-care and illness-related symptoms. This raises the potential for conflict when patients make choices that are contrary to recommendations. Barriers to facilitating participation identified were high clinician workloads and lack of time, and ambiguity of existing guidelines for supporting lifestyle decisions. Conclusion: Facilitating patient participation is complex in acute cancer care. Patient participation is recognized by nurses as a positive way of promoting independence in patients. However, balancing patient autonomy with nurses' perceived professional responsibilities is challenging in practice.