Kenny Dianna T
School of Behavioural and Community Health Sciences, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
Patient Educ Couns. 2004 Mar;52(3):297-305. doi: 10.1016/S0738-3991(03)00105-8.
This study examined interactions between doctors and their chronic pain patients in the context of investigations for medically unexplained pain. Doctor-patient interactions were explored through the analysis of the accounts of the communication process in the chronic pain consultation of 20 chronic pain patients with their pain specialists and the accounts of 22 pain specialists with their chronic pain patients. An implicit dialogue between doctors and their patients was identified that appeared to undermine the quality of their interactions, challenged each other's credibility and caused distress to both parties. The implicit dialogue of the chronic pain patient was based on the biogenic theory while the implicit dialogue of doctors was underpinned by psychogenic theory. Potentially healing interactions between doctors and their patients that do not rely on the biogenic model of the visible body or the psychogenic model of invisible pain are needed to assist the communication between chronic pain patients and their doctors. A systemic theoretical analysis of this process is offered.
本研究在对医学上无法解释的疼痛进行调查的背景下，考察了医生与其慢性疼痛患者之间的互动。通过分析20名慢性疼痛患者与疼痛专科医生进行慢性疼痛会诊时的沟通记录，以及22名疼痛专科医生与慢性疼痛患者的沟通记录，探讨了医患互动情况。研究发现医生与患者之间存在一种隐性对话，这种对话似乎破坏了他们互动的质量，质疑彼此的可信度，并给双方都带来了困扰。慢性疼痛患者的隐性对话基于生物成因理论，而医生的隐性对话则以心理成因理论为支撑。需要医生与患者之间建立不依赖于可见身体的生物成因模型或无形疼痛的心理成因模型的潜在治愈性互动，以促进慢性疼痛患者与医生之间的沟通。本文对这一过程进行了系统的理论分析。
