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患者对信息、决策和人际行为的偏好的最佳匹配:证据、模型与干预措施

Optimal matches of patient preferences for information, decision-making and interpersonal behavior: evidence, models and interventions.

作者信息

Kiesler Donald J, Auerbach Stephen M

机构信息

Virginia Commonwealth University, Department of Psychology, 808 W. Franklin Street, Box 842018, Richmond, VA 23284, USA.

出版信息

Patient Educ Couns. 2006 Jun;61(3):319-41. doi: 10.1016/j.pec.2005.08.002. Epub 2005 Dec 20.

Abstract

OBJECTIVE

A comprehensive review was conducted of the theoretical and empirical work that addresses the preference-match strategy in physician-patient communication.

METHODS

Searches were conducted on Medline, PsychINFO, InFoTrac One File Plus, Sociological Abstracts, and Dissertation Abstracts through 2004. The following keywords were used: patient preferred and received information; patient preferred and actualized treatment decision-making; patient-physician beliefs in shared decision-making; patient-physician match, fit, or concordance; reciprocal relationship or mutuality; doctor-patient affiliation, control, relationship; match/fit between patient and physician in affiliation, control, or relationship.

RESULTS

Findings revealed varying degrees of support for the positive effects of matching patients' preferred levels of information, decisional control, and consultative interpersonal behavior.

CONCLUSIONS

Findings justify not only continued but expanded research efforts in this area that would incorporate recommended changes in research design and implementation. PRACTICE AND RESEARCH IMPLICATIONS: Assessment strategies and match interventions are discussed that, if evidence continues to be supportive, might routinely optimize patient-physician encounters toward more positive outcomes. Methodological guidelines are suggested that can improve future preference-match studies of the patient-physician interaction. Practitioners need to consider adoption of patient-match assessment and intervention strategies in addition to recent exclusive concentrations on patient-centered and shared decision-making approaches.

摘要

目的

对涉及医患沟通中偏好匹配策略的理论和实证研究进行全面综述。

方法

截至2004年,在医学文献数据库(Medline)、心理学文摘数据库(PsychINFO)、信息检索数据库(InFoTrac One File Plus)、社会学文摘数据库(Sociological Abstracts)和学位论文文摘数据库(Dissertation Abstracts)中进行检索。使用了以下关键词:患者偏好及接收到的信息;患者偏好及实现的治疗决策;医患对共同决策的信念;医患匹配、契合或一致性;互惠关系或相互性;医患从属关系、控制权、关系;医患在从属关系、控制权或关系方面的匹配/契合。

结果

研究结果显示,对于匹配患者偏好的信息水平、决策控制权和咨询性人际行为所产生的积极效果,存在不同程度的支持。

结论

研究结果不仅证明在该领域继续开展研究的合理性,而且证明扩大研究力度的合理性,这将纳入研究设计和实施方面的建议性变革。实践与研究意义:讨论了评估策略和匹配干预措施,如果证据继续支持,这些措施可能会常规性地优化医患互动,以实现更积极的结果。提出了方法学指南,可改进未来医患互动的偏好匹配研究。除了近期对以患者为中心和共同决策方法的专注之外,从业者还需要考虑采用患者匹配评估和干预策略。

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