Fröjd C, Von Essen L
Department of Public Health and Caring Sciences, Section of Caring Sciences, University of Uppsala, Uppsala, Sweden.
Eur J Cancer Care (Engl). 2006 Sep;15(4):371-8. doi: 10.1111/j.1365-2354.2006.00670.x.
The aims were to investigate whether: (A) doctors' ability to identify patients' worry about prognosis/wish for information about disease and treatment is related to doctors' self-efficacy with regard to communicating about difficult matters and patients' satisfaction with a consultation/hope to live a good life in spite of the disease; and (B) patients and doctors agree on how much worry/wish for information a patient experiences/wishes. Sixty-nine patients with carcinoid and 11 doctors participated. Ability to identify worry/wish for information was estimated by posing questions to doctors/patients concerning how much worry/information a patient experienced/wished during a consultation. Doctors' self-efficacy was measured by nine questions, patients' satisfaction and hope by two questions. When doctors show good ability to identify wish for information, they report higher self-efficacy (t = 3.5, d.f. = 67, P < 0.001) than when they show less good ability. Patients finding the consultation very satisfying meet doctors reporting higher self-efficacy than patients finding the consultation satisfying (t = 2.26, d.f. = 65, P < 0.05). Doctors fail to identify patients who report less worry/wish more information than the average patient. The findings underscore the importance of further enhancing doctors' self-efficacy with regard to communicating about difficult matters and ability to identify patients who are less worried/wish more information than the average patient.
(A)医生识别患者对预后的担忧/对疾病和治疗信息的需求的能力,是否与医生在沟通困难问题时的自我效能感以及患者对会诊的满意度/尽管患病仍希望过上美好生活的愿望相关;以及(B)患者和医生在患者经历的担忧/对信息的需求程度上是否达成一致。69名类癌患者和11名医生参与了研究。通过向医生/患者提出关于患者在会诊期间经历的担忧/信息需求程度的问题,来评估识别担忧/对信息的需求的能力。通过九个问题测量医生的自我效能感,通过两个问题测量患者的满意度和希望。当医生表现出良好的识别信息需求的能力时,他们报告的自我效能感(t = 3.5,自由度 = 67,P < 0.001)高于表现较差时。认为会诊非常满意的患者所遇到的医生报告的自我效能感高于认为会诊满意的患者(t = 2.26,自由度 = 65,P < 0.05)。医生未能识别出那些报告的担忧少于/希望获得的信息多于平均水平患者的患者。这些发现强调了进一步提高医生在沟通困难问题时的自我效能感以及识别那些担忧少于/希望获得的信息多于平均水平患者的能力的重要性。