Munch Shari, Schmitz Mark F
School of Social Work, Rutgers, The State University of New Jersey, 536 George Street, New Brunswick, NJ 08901, USA.
J Psychosom Obstet Gynaecol. 2006 Mar;27(1):49-57. doi: 10.1080/01674820500243633.
To examine the relationship between patients' perceptions of the patient-physician relationship and patients' satisfaction with the overall medical care received from their physicians in the treatment of hyperemesis gravidarum (HG).
This study investigated patients' beliefs and their views of their physicians' beliefs about the causal explanation of HG, the seriousness of the illness, and the impact of the illness upon patients' daily lives. Also examined were the extent to which patients' beliefs were congruent with their perception of their physicians' beliefs, and patients' ratings of the humanistic characteristics of physicians they deemed important. Ninety-six respondents who had experienced at least one hospitalization from January 1993 through April 1997 responded to interview questions focusing on their HG illness experience. Using both quantitative and qualitative methodological approaches, a path model of patient perception factors associated with patient satisfaction was tested.
Perceived shared beliefs about the etiology of HG for a particular patient's illness were more important direct contributing factors of satisfaction than were the specific causal explanations. The length of the patient-physician relationship provided important indirect effects on patient satisfaction; three key mediating variables were patients' perceptions about physician humanism and perceived agreement about the cause and impact of HG. Pertinent qualitative findings are provided as additional sources of information to supplement the quantitative results.
Knowledge of the patient-physician relationship factors that influence HG women's satisfaction can be used to enhance service delivery and may ultimately improve perinatal outcomes.
探讨妊娠剧吐（HG）患者对医患关系的认知与患者对从医生处获得的整体医疗护理满意度之间的关系。
本研究调查了患者的信念以及他们对医生关于HG病因解释、疾病严重程度和疾病对患者日常生活影响的信念的看法。还考察了患者的信念与他们对医生信念的认知相符程度，以及患者对他们认为重要的医生人文特征的评分。96名在1993年1月至1997年4月期间至少有过一次住院经历的受访者回答了聚焦于他们HG患病经历的访谈问题。采用定量和定性方法，对与患者满意度相关的患者认知因素路径模型进行了检验。
对于特定患者的疾病，关于HG病因的感知共同信念比具体的因果解释更是满意度的重要直接促成因素。医患关系的时长对患者满意度产生重要的间接影响；三个关键中介变量是患者对医生人文关怀的认知以及对HG病因和影响的感知一致性。提供相关定性研究结果作为补充定量结果的额外信息来源。
了解影响HG女性满意度的医患关系因素可用于改善服务提供，并可能最终改善围产期结局。
