患者参与患者安全的系统评价_《中国循证医学杂志》

作者：

李雨璘 ^1,2 , 聂燕丽 ¹ , 黄燕 ¹ ,  张鸣明 ¹ , 李静 ¹

1. 四川大学华西医院中国循证医学中心（成都?610041）；2. 成都中医药大学第二附属医院（成都?610041）;

关键词：

患者参与患者安全系统评价

DOI：

10.7507/1672-2531.20110153

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价国内外患者参与患者安全的相关研究，并与我国患者参与患者安全的研究现状进行比较，为如何在我国开展患者参与患者安全教育，改进医疗质量提供循证决策建议。
方法　电子检索MEDLINE、EMbase、CBM，并追索纳入文献的参考文献，根据预先制定的纳入和排除标准筛选文献、提取数据，采用Cochrane Handbook 5.0和Critical Appraisal Skills Programme评价标准分析文献质量，采用定性研究方法综合分析资料。
结果　共纳入28篇文献，其中中文5篇，除1篇为随机对照试验外，其余均为横断面研究。定量或定性结果显示：① 患者对患者安全的认知度国内外都普遍贫乏，但患者参与患者安全的意愿较为强烈；② 患者参与的影响因素包括特征、疾病、情感；③ 3篇文献分别从感染、医疗差错、用药方面分析了患者的参与方式；④ 患者参与能有效促进医务人员规范操作，预防不安全事件发生，减少伤害；⑤ 所纳入的5篇中文文献的研究内容仅涉及患者对患者安全的认识、参与态度及影响因素。
结论　目前关于患者参与患者安全的研究尚少，更缺乏高质量的随机对照试验验证患者参与方式的有效性，提示今后的研究应加强患者参与患者安全后效果的评价。

引用本文： 李雨璘,聂燕丽,黄燕,张鸣明,李静. 患者参与患者安全的系统评价. 中国循证医学杂志, 2011, 11(8): 903-909. doi: 10.7507/1672-2531.20110153 复制

1.	2 Kennedy J. Special message to the Congress on protecting the consumer interest. Public Papers of the Presidents of the United States , 1962, 93: 236.
2.	段玉蓉, 艾昌林, 张鸣明. 病人安全基本理念及其沿革. 中华医史杂志, 2009, 39(5): 299-302.
3.	Higgins J, Green Se. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. www.cochrane-handbook.org.
4.	CASP. 10 questions to help you make sense of qualitative research 2006.
5.	Noblit G, Hare R. Meta-ethnography: synthesising qualitative studies. Newbury Park CA: Sage, 1988.
6.	Weingart SN, Toth M, Eneman J, et al . Lessons from a patient partnership intervention to prevent adverse drug events. Int J Qual Health Care , 2004, 16(6): 499-507.
7.	Abbate R, Di GG, Marinelli P, et al . Patients’ knowledge, attitudes, and behavior toward hospital-associated infections in Italy. Am J Infect Control , 2008, 36(1): 39-47.
8.	Burroughs TE, Waterman AD, Gallagher TH, et al . Patient concerns about medical errors in emergency departments. Acad Emerg Med , 2005, 12(1): 57-64.
9.	吴娴波, 柯雪梅, 王冬, 等. 医院门诊就诊人群医院感染知晓率的调查. 广东医学. 2007, 28(5): 802-804.
10.	柯雪梅, 吴娴波, 陈清. 医院门诊就诊人群医院感染的知信行调查. 护理学报, 2009, 16(21): 13-15.
11.	Gallagher TH, Waterman AD, Ebers AG, et al . Patients' and Physicians' Attitudes Regarding the Disclosure of Medical Errors. JAMA , 2003, 289(8): 1001-1007.
12.	Bernstein M, Potvin D, Martin DK. A qualitative study of attitudes toward error in patients facing brain tumour surgery. Can J Neurol Sci , 2004, 31(2): 208-212.
13.	Mazor KM, Simon SR, Yood RA, et al . Health plan members' views on disclosure of medical errors. Manag Care Interface , 2004, 17(5): 47, 51.
14.	Hibbard JH, Peters E, Slovic P, et al . Can patients be part of the solution? Views on their role in preventing medical errors. Medical Care Research and Review , 2005, 62(5): 601-616.
15.	Itoh K, Andersen HB, Madsen MD, et al . Patient views of adverse events: Comparisons of self-reported healthcare staff attitudes with disclosure of accident information. Appl Ergon , 2006, 37(4): 513-523.
16.	Waterman AD, Gallagher TH, Garbutt J, et al . Brief report: Hospitalized patients' attitudes about and participation in error prevention. J Gen Intern Med , 2006, 21(4): 367-370.
17.	Northcott H, Vanderheyden L, Northcott J, et al . Perceptions of preventable medical errors in Alberta, Canada. Int J Qual Health Care , 2008, 20(2): 115-122.
18.	凌秋英, 张晋昕, 许璧瑜, 等. 住院患者参与患者安全建设的情况及其影响因素分析. 护理学报, 2010, 17(16): 16-18.
19.	许璧瑜, 韩丹, 梁雪莹, 等. 患者参与患者安全的现状调查. 中华现代护理杂志, 2010, (24): 2877-2880.
20.	李颖, 武迎宏, 张丽洁. 门诊患者手卫生知识认知现状的调查分析. 中华医院感染学杂志, 2007, 17(3): 305-307.
21.	Davis RE, Koutantji M, Vincent CA. How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? An exploratory study. Qual Saf Health Care , 2008, 17(2): 90-96.
22.	Eldh AC, Ekman I, Ehnfors M. Considering patient non-participation in health care. Health Expect , 2008, 11(3): 263-271.
23.	Longtin Y, Sax H, Allegranzi B, et al . Patients' beliefs and perceptions of their participation to increase healthcare worker compliance with hand hygiene. Infect Control Hosp Epidemiol , 2009, 30(9): 830-839.
24.	McGuckin M, Waterman R, Shubin A. Consumer attitudes about health care-acquired infections and hand hygiene. Am J Med Qual , 2006, 21(5): 342-346.
25.	Duncan C. An exploratory study of patient’s feelings about asking healthcare professionals to wash their hands. J Ren Care , 2007, 33(1): 30-34.
26.	Luszczynska A, Gunson KS. Predictors of asking medical personnel about handwashing: The moderating role of patients’ age and MRSA infection status. Patient Educ Couns , 2007, 68(1): 79-85.
27.	Unruh KT, Pratt W. Patients as actors: the patient's role in detecting, preventing, and recovering from medical errors. Int J Med Inform , 2007, 76 Suppl 1: S236-44.
28.	McGuckin M, Waterman R, Storr IJ, et al . Evaluation of a patient-empowering hand hygiene programme in the UK. J Hosp Infect , 2001, 48(3): 222-227.
29.	McGuckin M, Taylor A, Martin V, et al . Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Am J Infect Control , 2004, 32(4): 235-238.
30.	Lent V, Eckstein EC, Cameron AS, et al . Evaluation of patient participation in a patient empowerment initiative to improve hand hygiene practices in a Veterans Affairs medical center. Am J Infect Control , 2009, 37(2): 117-120.
31.	Bittle MJ, LaMarche S. Engaging the patient as observer to promote hand hygiene compliance in ambulatory care. Jt Comm J Qual Patient Saf , 2009, 35(10): 519-525.
32.	Burnett E, Lee K, Rushmer R, et al . Healthcare-associated infection and the patient experience: a qualitative study using patient interviews. J Hosp Infect , 2010, 74(1): 42-47.
33.	Cumbler E, Wald H, Kutner J. Lack of patient knowledge regarding hospital medications. J Hosp Med , 2010, 5(2): 83-86.
34.	WHO启动“病人安全九项措施”. http://www.patientsafety.net.cn.

1. 2 Kennedy J. Special message to the Congress on protecting the consumer interest. Public Papers of the Presidents of the United States , 1962, 93: 236.
2. 段玉蓉, 艾昌林, 张鸣明. 病人安全基本理念及其沿革. 中华医史杂志, 2009, 39(5): 299-302.
3. Higgins J, Green Se. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. www.cochrane-handbook.org.
4. CASP. 10 questions to help you make sense of qualitative research 2006.
5. Noblit G, Hare R. Meta-ethnography: synthesising qualitative studies. Newbury Park CA: Sage, 1988.
6. Weingart SN, Toth M, Eneman J, et al . Lessons from a patient partnership intervention to prevent adverse drug events. Int J Qual Health Care , 2004, 16(6): 499-507.
7. Abbate R, Di GG, Marinelli P, et al . Patients’ knowledge, attitudes, and behavior toward hospital-associated infections in Italy. Am J Infect Control , 2008, 36(1): 39-47.
8. Burroughs TE, Waterman AD, Gallagher TH, et al . Patient concerns about medical errors in emergency departments. Acad Emerg Med , 2005, 12(1): 57-64.
9. 吴娴波, 柯雪梅, 王冬, 等. 医院门诊就诊人群医院感染知晓率的调查. 广东医学. 2007, 28(5): 802-804.
10. 柯雪梅, 吴娴波, 陈清. 医院门诊就诊人群医院感染的知信行调查. 护理学报, 2009, 16(21): 13-15.
11. Gallagher TH, Waterman AD, Ebers AG, et al . Patients' and Physicians' Attitudes Regarding the Disclosure of Medical Errors. JAMA , 2003, 289(8): 1001-1007.
12. Bernstein M, Potvin D, Martin DK. A qualitative study of attitudes toward error in patients facing brain tumour surgery. Can J Neurol Sci , 2004, 31(2): 208-212.
13. Mazor KM, Simon SR, Yood RA, et al . Health plan members' views on disclosure of medical errors. Manag Care Interface , 2004, 17(5): 47, 51.
14. Hibbard JH, Peters E, Slovic P, et al . Can patients be part of the solution? Views on their role in preventing medical errors. Medical Care Research and Review , 2005, 62(5): 601-616.
15. Itoh K, Andersen HB, Madsen MD, et al . Patient views of adverse events: Comparisons of self-reported healthcare staff attitudes with disclosure of accident information. Appl Ergon , 2006, 37(4): 513-523.
16. Waterman AD, Gallagher TH, Garbutt J, et al . Brief report: Hospitalized patients' attitudes about and participation in error prevention. J Gen Intern Med , 2006, 21(4): 367-370.
17. Northcott H, Vanderheyden L, Northcott J, et al . Perceptions of preventable medical errors in Alberta, Canada. Int J Qual Health Care , 2008, 20(2): 115-122.
18. 凌秋英, 张晋昕, 许璧瑜, 等. 住院患者参与患者安全建设的情况及其影响因素分析. 护理学报, 2010, 17(16): 16-18.
19. 许璧瑜, 韩丹, 梁雪莹, 等. 患者参与患者安全的现状调查. 中华现代护理杂志, 2010, (24): 2877-2880.
20. 李颖, 武迎宏, 张丽洁. 门诊患者手卫生知识认知现状的调查分析. 中华医院感染学杂志, 2007, 17(3): 305-307.
21. Davis RE, Koutantji M, Vincent CA. How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? An exploratory study. Qual Saf Health Care , 2008, 17(2): 90-96.
22. Eldh AC, Ekman I, Ehnfors M. Considering patient non-participation in health care. Health Expect , 2008, 11(3): 263-271.
23. Longtin Y, Sax H, Allegranzi B, et al . Patients' beliefs and perceptions of their participation to increase healthcare worker compliance with hand hygiene. Infect Control Hosp Epidemiol , 2009, 30(9): 830-839.
24. McGuckin M, Waterman R, Shubin A. Consumer attitudes about health care-acquired infections and hand hygiene. Am J Med Qual , 2006, 21(5): 342-346.
25. Duncan C. An exploratory study of patient’s feelings about asking healthcare professionals to wash their hands. J Ren Care , 2007, 33(1): 30-34.
26. Luszczynska A, Gunson KS. Predictors of asking medical personnel about handwashing: The moderating role of patients’ age and MRSA infection status. Patient Educ Couns , 2007, 68(1): 79-85.
27. Unruh KT, Pratt W. Patients as actors: the patient's role in detecting, preventing, and recovering from medical errors. Int J Med Inform , 2007, 76 Suppl 1: S236-44.
28. McGuckin M, Waterman R, Storr IJ, et al . Evaluation of a patient-empowering hand hygiene programme in the UK. J Hosp Infect , 2001, 48(3): 222-227.
29. McGuckin M, Taylor A, Martin V, et al . Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Am J Infect Control , 2004, 32(4): 235-238.
30. Lent V, Eckstein EC, Cameron AS, et al . Evaluation of patient participation in a patient empowerment initiative to improve hand hygiene practices in a Veterans Affairs medical center. Am J Infect Control , 2009, 37(2): 117-120.
31. Bittle MJ, LaMarche S. Engaging the patient as observer to promote hand hygiene compliance in ambulatory care. Jt Comm J Qual Patient Saf , 2009, 35(10): 519-525.
32. Burnett E, Lee K, Rushmer R, et al . Healthcare-associated infection and the patient experience: a qualitative study using patient interviews. J Hosp Infect , 2010, 74(1): 42-47.
33. Cumbler E, Wald H, Kutner J. Lack of patient knowledge regarding hospital medications. J Hosp Med , 2010, 5(2): 83-86.
34. WHO启动“病人安全九项措施”. http://www.patientsafety.net.cn.

《中国循证医学杂志》

患者参与患者安全的系统评价

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《中国循证医学杂志》

患者参与患者安全的系统评价

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

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