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[向患者提供的信息及其在临床决策中的参与情况]

[Information given to patients and their participation in clinical decision-making].

作者信息

Barca Fernández I, Parejo Miguez R, Gutiérrez Martín P, Fernández Alarcón F, Alejandre Lázaro G, López de Castro F

机构信息

Residente de tercer año de Medicina de Familia y Comunitaria, Unidad Docente de Medicina de Familia y Comunitaria, Toledo, España.

出版信息

Aten Primaria. 2004 Apr 30;33(7):361-4. doi: 10.1016/S0212-6567(04)78886-1.

Abstract

OBJECTIVES

To evaluate the information provided by physicians during consultations, the information requested by patients, and patients' participation in decision-making.

DESIGN

Descriptive, cross-sectional study based on observations of visits to the doctor's office and subsequent telephone interview.

SETTING

Primary care centers in Toledo, Spain.Participants. 152 clinical interviews.Interventions. Questionnaire with items on age, sex, types of information provided by the physician, information requested by the patient, and evaluation of the patient's participation in decision-making and degree of satisfaction.

MAIN MEASURES AND RESULTS

Mean age of the patients was 41.1 years, and 55.9% were women. The type of information given most frequently to patients was related to treatment (88.3%). Of the 152 patients whose visits were observed, 55 (36.2%) did not request additional information. The information requested most frequently when not provided spontaneously by the physician concerned treatment (35.3%) and cause of the symptoms (29.7%). Almost all patients (94.0%) considered the information received to be sufficient. However, 22.7% stated that when they left the doctor's office there was something they wished they had asked about, and 18.6% said they understood the doctor's explanations "in part." According to the observers, 69.4% of the patients did not take part in the decision about their treatment.

CONCLUSIONS

The information provided by the physician was not as complete as it might have been. Patients usually ask few questions, and a large percentage of patients had something they wished they had asked about, or did not fully understand the information. Patients' participation in decision-making was low.

摘要

目的

评估医生在会诊期间提供的信息、患者询问的信息以及患者在决策过程中的参与情况。

设计

基于对医生办公室就诊情况的观察及后续电话访谈的描述性横断面研究。

地点

西班牙托莱多的初级保健中心。参与者。152次临床访谈。干预措施。问卷内容包括年龄、性别、医生提供的信息类型、患者询问的信息,以及对患者参与决策情况和满意度的评估。

主要测量指标及结果

患者的平均年龄为41.1岁,55.9%为女性。最常向患者提供的信息类型与治疗相关(88.3%)。在观察到就诊情况的152名患者中,55名(36.2%)未询问额外信息。当医生未主动提供信息时,最常被询问的信息涉及治疗(35.3%)和症状原因(29.7%)。几乎所有患者(94.0%)认为所获得的信息足够。然而,22.7%的患者表示,当他们离开医生办公室时,有些问题他们希望自己当时问了,18.6%的患者表示他们“部分”理解医生的解释。据观察者称,69.4%的患者未参与关于其治疗的决策。

结论

医生提供的信息不如本应提供的那样完整。患者通常很少提问,且很大一部分患者有他们希望当时问了的问题,或者没有完全理解所提供的信息。患者在决策过程中的参与度较低。

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