患者參與患者安全的系統評價_《中國循證醫學雜志》

作者：

李雨璘 ^1,2 , 聶燕麗 ¹ , 黃燕 ¹ ,  張鳴明 ¹ , 李靜 ¹

1. 四川大學華西醫院中國循證醫學中心（成都?610041）；2. 成都中醫藥大學第二附屬醫院（成都?610041）;

關鍵詞：

患者參與患者安全系統評價

DOI：

10.7507/1672-2531.20110153

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價國內外患者參與患者安全的相關研究，并與我國患者參與患者安全的研究現狀進行比較，為如何在我國開展患者參與患者安全教育，改進醫療質量提供循證決策建議。
方法　電子檢索MEDLINE、EMbase、CBM，并追索納入文獻的參考文獻，根據預先制定的納入和排除標準篩選文獻、提取數據，采用Cochrane Handbook 5.0和Critical Appraisal Skills Programme評價標準分析文獻質量，采用定性研究方法綜合分析資料。
結果　共納入28篇文獻，其中中文5篇，除1篇為隨機對照試驗外，其余均為橫斷面研究。定量或定性結果顯示：① 患者對患者安全的認知度國內外都普遍貧乏，但患者參與患者安全的意愿較為強烈；② 患者參與的影響因素包括特征、疾病、情感；③ 3篇文獻分別從感染、醫療差錯、用藥方面分析了患者的參與方式；④ 患者參與能有效促進醫務人員規范操作，預防不安全事件發生，減少傷害；⑤ 所納入的5篇中文文獻的研究內容僅涉及患者對患者安全的認識、參與態度及影響因素。
結論　目前關于患者參與患者安全的研究尚少，更缺乏高質量的隨機對照試驗驗證患者參與方式的有效性，提示今后的研究應加強患者參與患者安全后效果的評價。

引用本文： 李雨璘,聶燕麗,黃燕,張鳴明,李靜. 患者參與患者安全的系統評價. 中國循證醫學雜志, 2011, 11(8): 903-909. doi: 10.7507/1672-2531.20110153 復制

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, 張鳴明. 病人安全基本理念及其沿革. 中華醫史雜志, 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.	吳嫻波, 柯雪梅, 王冬, 等. 醫院門診就診人群醫院感染知曉率的調查. 廣東醫學. 2007, 28(5): 802-804.
10.	柯雪梅, 吳嫻波, 陳清. 醫院門診就診人群醫院感染的知信行調查. 護理學報, 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, 張晉昕, 許璧瑜, 等. 住院患者參與患者安全建設的情況及其影響因素分析. 護理學報, 2010, 17(16): 16-18.
19.	許璧瑜, 韓丹, 梁雪瑩, 等. 患者參與患者安全的現狀調查. 中華現代護理雜志, 2010, (24): 2877-2880.
20.	李穎, 武迎宏, 張麗潔. 門診患者手衛生知識認知現狀的調查分析. 中華醫院感染學雜志, 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啟動“病人安全九項措施”. 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, 張鳴明. 病人安全基本理念及其沿革. 中華醫史雜志, 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. 吳嫻波, 柯雪梅, 王冬, 等. 醫院門診就診人群醫院感染知曉率的調查. 廣東醫學. 2007, 28(5): 802-804.
10. 柯雪梅, 吳嫻波, 陳清. 醫院門診就診人群醫院感染的知信行調查. 護理學報, 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, 張晉昕, 許璧瑜, 等. 住院患者參與患者安全建設的情況及其影響因素分析. 護理學報, 2010, 17(16): 16-18.
19. 許璧瑜, 韓丹, 梁雪瑩, 等. 患者參與患者安全的現狀調查. 中華現代護理雜志, 2010, (24): 2877-2880.
20. 李穎, 武迎宏, 張麗潔. 門診患者手衛生知識認知現狀的調查分析. 中華醫院感染學雜志, 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啟動“病人安全九項措施”. http://www.patientsafety.net.cn.

《中國循證醫學雜志》

患者參與患者安全的系統評價

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《中國循證醫學雜志》

患者參與患者安全的系統評價

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