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Democratie sanitaire, democratie en sante, empowerment des malades : quels que soient les vocables utilises, la participation des patients semble admise. D'objets de soins, ils seraient enfin reconnus par les institutions comme citoyens a part entiere, sujets conscients, responsables et capables. Un tel consensus est a interroger. L'histoire tumultueuse de la democratie sanitaire est faite de conflits, de compromis, de victoires et d'echecs. Contrairement aux idees recues, elle ne commence pas aux annees sida. Des le XIXe siecle les malades ont combattu pour etre entendus. Ils se sont organises et ont ete actifs. Comment ont-ils contribue a impulser une dynamique democratique ? Sous quelles formes se developpe-t-elle actuellement ? Quelles sont les ambiguites des dispositifs institutionnels contemporains ?Alors que nous avons celebre les 20 ans de la loi sur les droits des malades, les difficultes du passe aident a comprendre les tensions persistantes du present. Par cette mise en perspective completee par une enquete de terrain en milieu hospitalier, Lucile Sergent pose un regard neuf sur le rapport des citoyens au systeme de sante. Elle propose de nouvelles ressources et un outillage pour penser la participation des malades et les politiques mises en ¿uvre.
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Les bénéfices de l'éducation thérapeutique pour le patient en termes de qualité de vie, de réduction du nombre des complications, de diminution du nombre d'hospitalisations, de meilleure observance des prises médicamenteuses et recommandations hygiéno-diététiques sont évidents. Cet aide-mémoire fait le tour des initiatives et bonnes pratiques mises en œuvre pour favoriser et développer une communication utile et efficace vers les patients. Il aidera les professionnels de la santé à intégrer l'éducation thérapeutique du patient, une réelle démarche d'apprentissage, dans leur pratique des soins.
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There are a number studies related to patients' satisfaction with health care. Since the Baltic States regained independence in 1990, a reform of the health care system took place in which a serious consideration is paid to health care quality. Patients' views are becoming increasingly important in the current health system. They provide information on effectiveness of healthcare and how it may be improved.The main objective of this study was to investigate inpatients experiences with the care and treatment given in Klaipeda hospitals in order to improve the quality of care and patients' satisfaction. Material and methods. A cross-sectional survey with questionnaires was made. The subjects of the investigation were patients (from 18 years old), hospitalized in internal and surgery departments in different Klaipeda city hospitals. The survey questions were divided into sections that broadly followed the patient's experience in the hospital. The analyses included descriptive statistics, interrelationship analysis between the different characteristics, and multiple logistic regression to estimate Odds for each of the independent variables in the model.Results. The study shows that 60-80 % of the respondents were satisfied with different parts and aspects of health care services. Satisfaction with getting enough time for discussion with the doctor was higher for younger, male and employed patients. Those from the city needed more understandable explanation from doctor about health condition or treatment plan. Doctors listened more to male patients compare to female. Those results were statistically significant. Conclusions. Majority of the patients were satisfied with hospitalization order in Klaipeda hospitals. Better physician communication skills can improve patient satisfaction and clinical outcomes. Physicians could more effectively facilitate patient involvement by more frequently using partnership-building and supportive communication.
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Family-centered rounds (FCRs) are multidisciplinary rounds that involve medical teams partnering with patients and families in daily medical decision-making. Multiple FCR benefits have been identified including improving patient satisfaction, communication, discharge planning, medical education, and patient safety. Main barriers to FCRs are variability in attending rounding, duration of rounds, physical constrains of large teams and small rooms, specific and sensitive patient conditions, and lack of training of residents, students, and faculty on how to conduct effective and effecient FCRs. In the last decade, many programs have incorporated FCRs into daily practice due to their multiple perceived benefits. Future FCRs should focus on better operationalizing of FCRs and reporting on objective outcomes measures such as improved communication, coordination, and patient satisfaction that are crucial for healthcare.
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