在患者和提供者之间报告的多发性硬化症临床过程的不一致性
Albert Aboseif1, Moein Amin2, Gabrielle Macaron3
1Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Center for Multiple Sclerosis and Autoimmune Neurology, Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN, USA.
Journal of neuroimmunology
|August 30, 2024
概括
提供者和患者对多发性硬化症 (MS) 病程的一致意见仅为64%,表明需要改善沟通. 根据患者人口统计学情况,一致性有所不同,突出显示了MS护理中的潜在差异.
科学领域:
- 神经学 神经学
- 临床交流 临床沟通
- 患者报告的结果
背景情况:
- 医疗保健提供者与多发性硬化症患者 (pwMS) 之间的有效沟通对于最佳护理至关重要.
- 了解患者和医疗服务提供者对疾病过程的一致性对于管理多发性硬化症 (MS) 至关重要.
研究的目的:
- 评估医疗保健提供者和pwMS之间关于多发性硬化症报告的疾病过程的协议水平.
- 确定影响MS病程报告一致性的因素.
主要方法:
- 从2015年12月到2020年4月,对1335名患者进行了回顾性审查.
- 患者自我报告的多发性硬化症病程与提供者文档的比较.
- 使用科恩的卡帕测量协议的统计分析,按性别,种族和教育水平分层.
主要成果:
- 提供者和pwMS之间的整体一致性为64%,科恩的kappa为0.312.
- 与复发性复发性复发 (RRMS) 相比,在不同的MS疾病过程中,协议有显著的差异.
- 在女性,黑人和更受过高等教育的患者 (>14岁) 中观察到更高的一致性.
结论:
- 患有多发性硬化症的患者和他们的医疗服务提供者之间存在关于疾病进展的低最佳协议.
- 感知到MS疾病过程中的差异需要进一步调查和有针对性的沟通策略.
- 解决沟通差距可以改善对多发性硬化症的理解和管理.
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