【原】医院病房的质量和安全氛围、家庭成员赋权和满意度之间的关系（#护理SCI）

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Burlakov, N., Rozani, V., Bluvstein, I. and Kagan, I. (2021), The Association Between Quality and Safety Climate of a Hospital Ward, Family Members’ Empowerment, and Satisfaction With Provided Care. Journal of Nursing Scholarship, 53: 727-736. https:///10.1111/jnu.12682

医院病房的质量和安全氛围、家庭成员赋权和满意度之间的关系

Purpose研究目的

This study was designed to examine the perceptions of ward quality and safety held by family members and nurses, and investigate its impact on family members' empowerment, and satisfaction with patient hospitalization.

本研究旨在探讨家属及护士对病房质量和安全氛围的认知，以及其对家庭赋权能力和住院满意度的影响。

Design研究设计

A cross-sectional study on two study groups was conducted at a large public hospital in Israel. The first group comprised 86 family members of patients hospitalized for more than 72 hours in acute critical condition in intensive care units (ICU) or general wards (GW). The second group included 101 registered nurses who treated the patients in the ICU or GW.

在以色列的一家大型公立医院对两个研究组进行了横断面研究。第一组包括在重症监护病房(ICU)或普通病房(GW)住院超过72小时的急性危重症患者的86名家属。第二组包括ICU或GW中101 名注册护士。

Methods研究方法

Data were collected by a validated self-administered structured questionnaire. All participants voluntarily signed an informed consent and answered questions related to their demographic characteristics, perceptions, and attitudes toward quality and safety climate, empowerment, and satisfaction with the patients' hospitalization. Pearson correlations coefficient, t-test for independent samples, and a multiple regression model were performed to analyze the data.

数据通过经过自我填写结构化问卷进行收集，所有参与者自愿签署知情同意书。问卷包括：一般资料调查表、病房质量与安全氛围、赋权和对患者住院治疗的满意度。进行Pearson相关分析、独立样本的t检验和多元回归分析。

Findings研究结果

The mean age of family members was 51.4 ± 14.1 years and of nurses was 40.9 ± 9.9 years. A significant positive association was found between ward quality and safety climate and empowerment of the family member (r = .716; p < .001); empowerment of the family member and family members' satisfaction with the patients' hospitalization (r = .695; p < .001); and ward safety and quality climate and family members' satisfaction with the patients' hospitalization (r = .763; p <.001). Family members ranked ward quality and safety climate (M = 4.20 ± 0.60 vs. M = 3.61 ± 0.40), and their satisfaction with the patients' hospitalization (M = 4.49 ± 0.69 vs. M = 4.07± 0.54), which were significantly (p < .001) higher than the nurses’ estimate. The significant predictors for family members’ satisfaction with patients' hospitalization were commitment to quality leadership (b = .210; p = .027); implementing a quality improvement (b = .547; p < .001); and hand-off communication (b = .299; p = .001).

（1）家庭成员的平均年龄为51.4±14.1岁，护士的平均年龄为40.9±9.9岁。（2）病房质量和安全氛围与家庭成员赋权能力之间存在显着的正相关（r=0.716；p<0.001）；家庭成员赋权能力和对患者住院的满意度存在正相关（r=0.695；p<0.001）；病房安全和质量氛围与家属对患者住院的满意度存在正相关（r=0.763；p<0.001）。家属对病房质量和安全气氛（M=4.20±0.60vs.M=3.61±0.40）和患者住院治疗满意度（M=4.49±0.69vs.M=4.07±0.54）的评价显着高于（p<0.001)护士对其的估计/评价。（3）家属对患者住院满意度的重要预测因素是高品质领导承诺（b=0.210；p=0.027）；实施质量改进（b=0.547；p<0.001）和交接沟通（b=0.299；p=0.001）。

Conclusions研究结论

Positive relationships between quality and safety climate, empowerment, and satisfaction with patients' hospitalization suggest that by improving the ward quality and safety climate, and family empowerment, we may also improve family satisfaction. Although family members reported being satisfied with hospitalization in the ICU and GW, quality leadership and implementing a quality improvement among the nurses and hand-off communication between nurses and patients' families, will be targeted to improve family satisfaction with the patients’ hospitalization.

质量和安全氛围、赋权和患者住院满意度之间的正相关表明，通过改善病房质量和安全氛围以及家庭赋权，我们也可以提高家庭满意度。 尽管家属对ICU和GW的住院情况表示满意，但应针对性的提高对高品质领导承诺和质量改进以交接沟通等，以提高家属对患者住院的满意度。

Clinical Relevance对临床意义

Nurses who provide care for patients in a critical condition should maintain high levels of safety and quality care in order to improve the patients’ family empowerment and satisfaction. Specifically, their efforts should target a commitment to quality leadership, implementing quality improvement, and hand-off communication.

为危重病人提供护理的护士应保持高水平的安全和优质护理，以提高患者家属的赋权和满意度。具体来说，应针对性的提高高品质领导承诺、实施质量改进和交接沟通。