患者与医生的关系. 患者与医生在门诊息治疗期间的沟通:一项观察性研究
S B Detmar1, M J Muller, L D Wever
1Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands.
JAMA
|March 20, 2001
概括
在息性癌症治疗期间,医生对患者生活质量 (HRQL) 的沟通是有限的. 患者报告的HRQL显著影响了讨论,但许多严重的问题,特别是情绪健康和疲劳,仍然没有得到解决.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗服务研究 医疗服务研究
- 在医疗保健领域的沟通
背景情况:
- 改善与健康相关的生活质量 (HRQL) 是缓解癌症护理的一个关键目标.
- 目前对患者和医生在息治疗期间对HRQL沟通的理解有限.
研究的目的:
- 分析关于四个特定HRQL问题的例行患者瘤学家沟通内容.
- 确定与HRQL讨论相关的患者,医生和访问相关因素.
主要方法:
- 一项观察性研究是在门诊息化疗诊所进行的.
- 从10名瘤学家和240名患有无法治愈的癌症的患者收集了数据,使用问卷和音频带分析.
- 罗特互动分析系统用于分析有关日常活动,情绪功能,疼痛和疲劳的沟通.
主要成果:
- 医生将64%的咨询时间用于医疗/技术问题,而23%用于HRQL问题.
- 患者更平等地讨论医疗/技术问题 (41%) 和HRQL主题 (48%).
- 患者报告的HRQL是讨论HRQL的最强预测因素,但20-54%的严重HRQL问题,特别是情绪功能和疲劳,没有得到解决.
结论:
- 在息性癌症护理中,患者与医生的关于HRQL的沟通是有限的.
- 关于HRQL的明确沟通在实践中对治疗疗效评估做出了适度的贡献.
- 需要进一步的研究来加强沟通策略,以改善患者的HRQL.
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