Thorne Sally E, Harris Susan R, Mahoney Karen, Con Andrea, McGuinness Liza
University of British Columbia School of Nursing, T201-2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
Patient Educ Couns. 2004 Sep;54(3):299-306. doi: 10.1016/j.pec.2003.11.009.
Patient-professional communication is a critically important element of effective chronic illness care. However, the dynamics of health care communication in supporting self-care management and effective coping with various chronic diseases is not well understood. The present study examined health care communication from the perspective of 38 patients with four distinct chronic conditions: end-stage renal disease (ESRD), non-insulin dependent diabetes mellitus (NIDDM), multiple sclerosis (MS), and fibromyalgia (FM). Analysis revealed the dimensions of courtesy, respect, and engagement to be inherent in communication priorities across conditions. However, distinct "disease worlds" among and between these chronic conditions illuminated salient differences within these dimensions, thereby illustrating the way in which relevant variables such as legitimacy, the availability of conventional treatments, and lifestyle implications shape the meaning of health care communication. The findings enlarge upon patient-centered approaches to health care communication and inform further analysis of the interactional dynamics associated with chronic conditions.
患者与医护人员之间的沟通是有效慢性病护理的一个至关重要的因素。然而，人们对医疗保健沟通在支持自我护理管理和有效应对各种慢性病方面的动态情况了解不足。本研究从38名患有四种不同慢性病的患者角度审视了医疗保健沟通，这四种慢性病分别是终末期肾病（ESRD）、非胰岛素依赖型糖尿病（NIDDM）、多发性硬化症（MS）和纤维肌痛（FM）。分析表明，礼貌、尊重和参与是各类疾病沟通重点中固有的维度。然而，这些慢性病之间以及内部不同的“疾病世界”揭示了这些维度内的显著差异，从而说明了诸如合理性、传统治疗方法的可用性以及生活方式影响等相关变量如何塑造医疗保健沟通的意义。这些发现丰富了以患者为中心的医疗保健沟通方法，并为进一步分析与慢性病相关的互动动态提供了信息。
