| Research backgroundAt present,continuous improvement of the quality of medical service is the direction of the reform of public hospitals and a significant issue concerning the reform and development of Chinese health undertakings.With the increasing incidence of malignant tumor year by year in our country,it is clearly proposed by many departments that we should establish a medical service system covering the whole process of tumor diagnosis and treatment,standardize the application of medical technology,and focus on the process management of tumor patients.At present,125I is the main radioactive particle used in the clinic,and its internal radiotherapy has been recognized as a useful and effective treatment for a variety of advanced cancers,which can improve the quality of life of patients.However,current studies on the evaluation of radioactive particle implantation are mainly reflected in postoperative clinical effect indicators,and lack of attention to patients’ diagnosis and treatment experience,which is not conducive to promoting the realization of the whole-process management policy objectives for cancer patients.At present,the number of patients with 125I seed implantation in Y Hospital is increasing year by year.However,in the management of patients with radioactive seed implantation,the satisfaction of relevant departments is lower than the average level of the hospital.Therefore,it is urgent to carry out research on the diagnosis and treatment experience of patients with seed implantation,so as to provide basis for improving the whole process service experience of tumor patients.Research purposeThe objective of this study was to design the SERVQUAL scale for 125I implantation patients;The scale was used to investigate the actual perception and expectation of 125I seed implantation patients in a Grade-Ⅲ hospital in Shandong Province,analyze the gap between them,and excavate the problems existing in the process of seed implantation in this hospital.Put forward the strategy of optimizing the service process of 125I implantation in Y Hospital,and put forward feasible suggestions for the hospital to simplify procedures and improve service quality.Research results(1)Cronbach a was 0.827>0.8 and KMO was 0.704>0.7 in the SERVQUAL expectationperception scale.The expected reliability coefficient Cronbach α value was 0.781>0.7,and the validity KMO value was 0.718>0.7.The reliability and validity of the scale were both in the acceptable range.(2)Patients with 125I seed implantation had a general experience,with a total score of 17.52 for perceived value and a total score of 21.88 for expected value.Reliability was the dimension with the highest score,and empathy was the dimension with the biggest gap.The first three indexes patients expected to improve most were:The style of medical staff,the technical and operational ability of doctors,and the therapeutic effect were expected to improve.On the contrary,patients had low expectations for improvement in the three aspects of doctors’ ward round frequency,the clarity of costs,and the timeliness of surgery.(3)Investigating the impact of patients’ occupation,education level,medical insurance type,previous treatment methods,number of implanted particles,and self-efficacy on patients’perception perception scores was statistically significant.Enterprise employees and farmers generally have lower scores.The higher their education level,the greater the difference between patient perception and expectation.Urban employees with medical insurance have higher scores on various perceived evaluation indicators than other types of medical insurance,and they have higher expectations for the application of commercial insurance in radioactive particle technology.Patients who had received other treatments or had not been implanted with particles for the first time had higher evaluation scores,while patients with a high sense of self-efficacy had higher scores.The main factors affecting the quality of patient visits are the following three aspects:the work style of medical personnel;Long waiting time for patients to enter the hospital;Lack of logistics support,covering three links:service,hospital admission,and logistics support.(4)Based on in-depth interviews with patients and medical staff,it is concluded that the reasons affecting patients’ medical treatment experience are mainly concentrated in the following four aspects:first,the shortage of doctors’ human resources is an important factor for patients’ medical treatment difficulties;Second,the current training methods and performance evaluation system are difficult to stimulate the internal motivation of high-level technical personnel;Third,the limited scope of information and the lack of auxiliary tools make the postoperative doctors undertake too much unnecessary communication and increase the workload of doctors.Fourthly,the whole hospital has not formed unified standardized implementation guidelines for technology,and the implementation standards of MDT are inconsistent,resulting in problems such as not timely preoperative examination and inconsistent protection requirements.Conclusion and suggestionThis study designed and used the 125I Radioactive Particle Implantation SERVQUAL scale,which has good reliability and validity,and can be used for follow-up research.The scale is used to investigate patients’ evaluation of 125I radioactive particle implantation.Patients undergoing particle implantation have a general perception of 125I particle service quality,with expectations at a high level,and there is a gap between expectations and perceptions.Based on the qualitative and quantitative differential evaluation of patients,it can be seen that patients with higher education levels have higher requirements for convenience in seeking medical treatment;Previous treatment experience facilitates patients to deepen their understanding of particle implantation;Patients with a high sense of self-efficacy have a higher recognition of treatment methods and effects;The main reasons for the problem are as follows:First,the shortage of high-level technical personnel is one of the root causes of long waiting times for patients;The second is that the whole process supervision of particles is still not perfect,and the service awareness of hospital management departments is weak;Third,there are many barriers to multidisciplinary diagnosis and treatment,and the efficiency of collaboration among various departments is relatively low.Based on the results of this study,the following recommendations are made:(1)Strengthen the service consciousness of administrative departments and strengthen the guarantee of medical service quality;(2)Pay attention to patients returning to different places,strengthen the construction of hospital information and patient record system;(3)Rationalize multidisciplinary diagnosis and treatment procedures to improve the accuracy of patient treatment;(4)Construct a talent training path for particle implantation to alleviate the difficulty of admission;(5)Implement the regulatory process of restricted technologies to promote the standardized use of radioactive particles. |
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