环境影响对健康结果的影响:系统性审查
Z Di Blasi1, E Harkness, E Ernst
1Department of Health Sciences and Clinical Evaluation, University of York, NHS Centre for Reviews and Dissemination, UK. zdb1@york.ac.uk
医生与患者的关系显著影响治疗结果. 一个温暖,放心的医生方式,结合积极的患者期望,明显改善健康,强调非治疗护理的重要性.
科学领域:
- 医学社会学 医学社会学
- 心理学 心理学 心理学
- 基于证据的医学基于证据的医学.
背景情况:
- 医生与病人关系的治疗价值在历史上是公认的.
- 支持这种治疗效果的经验证据需要进行系统的调查.
研究的目的:
- 系统地审查医生与病人关系对治疗效果的经验证据.
- 评估认知和情感护理在医疗咨询中的影响.
主要方法:
- 对11个电子数据库 (医学,心理学,社会学) 的系统审查.
- 由两个独立审查员对25项符合条件的随机对照试验进行质量评估.
- 非治疗护理的分类是认知 (影响期望) 和情感 (咨询风格).
主要成果:
- 19项试验检查了影响患者期望的因素;50%显示显著影响.
- 没有试验孤立了情绪护理,但4个试验结合了认知和情绪护理.
- 三项试验将积极的期望与放心结合起来,显著改善了健康结果.
结论:
- 在医生与患者的互动中,认知和情感护理的证据是不一致的.
- 采用温暖,友好和安慰的方法的医生比那些保持正式,非安慰咨询的医生更有效.
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