Gopinath B, Radhakrishnan K, Sarma P S, Jayachandran D, Alexander A
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Epilepsy Res. 2000 Mar;39(1):73-82. doi: 10.1016/s0920-1211(99)00112-6.
To date, very few studies have investigated patients' views on the information they receive from the doctor concerning epilepsy and its management. Little information is available about the influence of doctor-patient communication and locus of control on the compliance of persons with epilepsy. We investigated, through a questionnaire-interview design, among patients attending the epilepsy clinic of a tertiary referral center in South India, their views about the provision of information by the doctor, and their compliance and locus of control. We also determined the interrelation between doctor-patient communication, compliance and locus of control. Our subjects comprised 200 adult persons with epilepsy, 113 males and 87 females, mean age 30.5 (range 18-67) years. Over one-third of the subjects received from the doctor insufficient information about epilepsy and its treatment. There was a significant positive correlation between effective doctor-patient communication and compliance. A majority of our patients had an external locus of control, which negatively influenced the compliance. Even in a comprehensive epilepsy clinic of a model tertiary referral center in a developing country, a significant proportion of patients do not receive optimal information about epilepsy from the doctor. Knowledge about their disease will encourage people with epilepsy to make informed choices, and achieve better compliance and personal control of their problems. Educating primary and secondary care physicians about the importance of doctor-patient communication in the management of epilepsy and educating the public about the positive aspects of life in epilepsy cannot be overemphasized.
迄今为止，很少有研究调查患者对从医生那里获得的有关癫痫及其治疗信息的看法。关于医患沟通和控制源对癫痫患者依从性的影响，目前所知甚少。我们通过问卷调查-访谈设计，对印度南部一家三级转诊中心癫痫门诊的患者进行了调查，了解他们对医生提供信息的看法、他们的依从性和控制源。我们还确定了医患沟通、依从性和控制源之间的相互关系。我们的研究对象包括200名成年癫痫患者，其中男性113名，女性87名，平均年龄30.5岁（范围18 - 67岁）。超过三分之一的研究对象从医生那里获得的关于癫痫及其治疗的信息不足。有效的医患沟通与依从性之间存在显著的正相关。我们的大多数患者具有外部控制源，这对依从性产生了负面影响。即使在一个发展中国家的模范三级转诊中心的综合癫痫门诊，仍有相当比例的患者没有从医生那里获得关于癫痫的最佳信息。了解自己的疾病将鼓励癫痫患者做出明智的选择，并更好地依从治疗以及对自身问题进行自我控制。强调初级和二级护理医生了解医患沟通在癫痫治疗中的重要性以及向公众宣传癫痫患者积极生活方面的知识，无论怎么强调都不为过。
