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结构化沟通工具对医学上无法解释的身体症状的患者的影响:一个集群随机试验
Cathrine Abrahamsen1, Silje Endresen Reme2, Knut Reidar Wangen3
1Faculty of Medicine, Department of General Practice, University of Oslo, Oslo, Norway.
一种新的沟通工具显著改善了医学上无法解释的身体症状 (MUPS) 的患者的功能和生活质量. 该干预措施还大幅减少了病假,证明了其在初级保健机构的有效性.
科学领域:
- 主要护理医学 医疗保健
- 精神病体医学是一种精神病体医学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医学上无法解释的身体症状 (MUPS) 在初级保健中很常见,影响患者的生活质量并增加医疗保健成本.
- 需要有效的干预措施来管理MUPS,并在常规临床实践中改善患者的结果.
研究的目的:
- 评估以认知行为治疗为基础的以工作为中心的结构化沟通工具,个人挑战清单工具 (ICIT) 的有效性.
- 评估ICIT对患者报告结果的影响,包括MUPS患者的功能,症状,生活质量和病假.
主要方法:
- 一个挪威的双臂集群随机试验,涉及103名全科医生和541名患有MUPS的患者.
- 患者被随机分配,接受ICIT干预或通常的护理11周.
- 结果包括患者的全球变化印象 (PGIC),病假,与工作有关的自我效能 (RTW-SE) 和与健康有关的生活质量 (RAND-36).
主要成果:
- 在ICIT组中,76%的患者表现出功能,症状和生活质量的显著改善,而在常规护理组中这一比例为38% (p < 0.0001).
- 干预组的病假减少了27个百分点,而通常护理组的病假减少了4个百分点.
- 在与工作有关的自我效能,与健康有关的生活质量以及患者对ICIT小组咨询的满意度方面也观察到显著的改善.
结论:
- 个人挑战库存工具 (ICIT) 是一种有效的干预措施,可以在初级保健环境中改善MUPS患者的治疗结果.
- 实施ICIT可以改善患者的功能和生活质量,并大大减少病假.
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