پديد آورندگان :
والي، ليلا دانشگاه علوم پزشكي كرمان - مركز تحقيقات مهندسي بهداشت محيط، كرمان، ايران , گودرزي، رضا دانشگاه علوم پزشكي كرمان - دانشكده مديريت و اطلاع‌رساني پزشكي - گروه مديريت، سياست‌گذاري و اقتصاد سلامت،كرمان، ايران , آذري، گلناز دانشگاه علوم پزشكي كرمان - مركز تحقيقات مهندسي بهداشت محيط، كرمان، ايران , قرباني نيا، راحيل دانشگاه علوم پزشكي كرمان - دانشكده مديريت و اطلاع‌رساني پزشكي - گروه مديريت، سياست‌گذاري و اقتصاد سلامت،كرمان، ايران
كليدواژه :
خدمات سلامت , بيمارستان , بيمار , بستري مجدد , مطالعه كيفي
چكيده فارسي :
زمينه و هدف: كاهش بستري مجدد به‌عنوان يك شاخص تعيين‌كننده عملكرد سيستم‌هاي مراقبتي و درماني، نشان‌دهنده افزايش كيفيت خدمات در اولين مراقبت ارايه شده به بيمار است.
روش بررسي: اين مطالعه كيفي از نوع فنومنولوژي (Phenomenology) بود كه در سه بيمارستان آموزشي شهر كرمان از فروردين تا شهريور سال 1396 انجام شد. گردآوري داده‌ها از طريق مصاحبه‌هاي نيمه ساختار‌يافته با روش نمونه‌گيري هدفمند از بين تمامي بيماران بستري در بخش‌هاي داخلي و پرستاران شاغل در بخش و پزشكان معالج انجام شد. براي تحليل داده‌ها از روش كلايزي هفت مرحله‌اي (Seven Level Colaizzi Method) استفاده شد.
يافته‌ها: تحليل مصاحبه‌ها منجر به شناسايي سه كد اصلي شامل ويژگي‌هاي شخصي بيماران، نيروي انساني و عوامل باليني، بيمارستان و عوامل محيطي و 11 كد فرعي شد.
نتيجه‌گيري: بايد با ارايه راهكارهاي كاربردي و اجراي آن از طريق سيستم بهداشت و درمان كشور، زمينه لازم را براي كاهش ميزان بستري مجدد جامعه فراهم آورد.
چكيده لاتين :
Background: Currently many hospitals around the country face increasing demands of
their patients and readmission.The rate of readmission is a useful indicator for
determining the performance of healthcare system and it shows the quality of services
in the medical institutions. Readmissions have high economic, social and financial
impact and studying the related factors seems to be high priority for healthcare systems.
Methods: This qualitative study performed by phenomenological method in three
educational hospitals in Kerman from April to September of 2017. Data collection was
performed through semi-structured interviews using targeted sampling among all
patients who were hospitalized at internal medicine wards, nurses who were working in
those wards, and in charge physicians. In total twenty patients, fifteen nurses, and five
physicians were selected for interviews. The including criteria were for patients, the
history of hospitalization at least once, during one month after the initial
hospitalization, and for service providers, familiarity with the subject, work experience
in the relevant department of at least three years for nurses and five years for
physicians. A seven-step clustering method was used to analyze the data.
Results: The analysis of the interviews led to the identification of three main themes
and 11 sub-themes. The main themes included patients' characteristics, manpower and
clinical factors, hospital, and environmental factors. Some of the sub-codes included
economic and living conditions, marriage status, insurance coverage, patients' beliefs
and expectations, the presence or absence of underlying disease, education, lifestyle
habits, dietary beliefs of hospitalized patients, lack of trust in medical staff,
communication and cultural barriers, ignorance of service providers in treatment, lack
of facilities, lack of motivation in medical staff, stressors and finally lack of hospital
equipment.
Conclusion: By providing practical solutions and implementing them through the
healthcare system of our country, the necessary baseline must be designed to reduce the
rate of re-hospitalization in our communities.
