了解医生与湿疹和牛皮患者之间的疾病严重性的不一致感知,使用结构方程建模
Valencia Long1, Zhaojin Chen2,3, Ruochen Du3
1Division of Dermatology, Department of Medicine, National University Healthcare System, Singapore.
JAMA dermatology
|July 12, 2023
概括
患者和医生对疾病严重程度的看法往往不同,影响了他们的关系. 这项研究确定了诸如症状表现和生活质量受损等因素,这些因素导致了严重程度分级不一致 (DSG).
科学领域:
- 皮肤病学 皮肤病学
- 健康心理学 心理健康心理学
- 医学社会学 医学社会学
背景情况:
- 患者和医生对疾病严重程度的看法经常有所不同,这种现象被称为不一致的严重程度分级 (DSG).
- DSG可能会对患者与医生的关系产生负面影响,并导致患者丧.
- 了解导致DSG的因素对于改善患者护理和沟通至关重要.
研究的目的:
- 验证一个理论模型,解释与异调严重程度分级 (DSG) 相关的认知,行为和疾病相关因素.
- 确定可改变的因素,这些因素有助于患者和医生之间疾病严重程度评估的差异.
主要方法:
- 为了验证从先前的定性研究中获得的模型,进行了前性,横截面的定量研究.
- 使用结构方程建模 (SEM) 分析了来自新加坡三个中心的1053名皮肤病患者和44名医生的数据.
- 疾病严重程度使用0-10数值评分尺度进行评估,不一致性定义为差异大于2分.
主要成果:
- 显著比例的患者和医生对 (46.3%) 呈现出不一致的严重程度分级,与糟糕的协议 (类内相关性 = 0.27).
- 阳性异调与更高的症状表现和更大的生活质量损害有关.
- 生活质量受损与抵御能力降低,增加负面社会比较,自我效能降低,疾病周期性和慢性期望等因素进一步相关.
结论:
- 该研究成功验证了一种模型,解释了皮肤病患者异调严重程度分级 (DSG) 的关键贡献者.
- 确定了可修改的因素,包括症状负担和生活质量影响,为干预提供了目标.
- 这项研究为开发策略提供了框架,以减少疾病严重程度感知中的差异,并增强患者与医生的沟通.
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