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医患沟通中的勃起功能障碍:解决性问题的优化策略及使用患者问卷的益处

Erectile dysfunctions in patient-physician communication: optimized strategies for addressing sexual issues and the benefit of using a patient questionnaire.

作者信息

Hartmann Uwe, Burkart Martin

机构信息

Clinical Psychology, Hannover Medical School, Hannover, Germany;.

Medical Affairs, Pfizer Pharma Germany, Karlsruhe, Germany.

出版信息

J Sex Med. 2007 Jan;4(1):38-46. doi: 10.1111/j.1743-6109.2006.00385.x. Epub 2006 Nov 6.

Abstract

INTRODUCTION

Erectile dysfunctions are prevalent but underdiagnosed and undertreated health problems. Communication barriers between patients and physicians are one of the main reasons for this and responsible for a low report rate of sexual dysfunction.

AIM

The main aim of the study was to investigate which phrasing and communication strategies gained the highest acceptance from physicians and their patients and were considered the most effective.

MAIN OUTCOME MEASURES

A documentation form on which each consultation was rated by the participating physicians.

METHODS

A large group of physicians was asked to hand out a short patient questionnaire to all male patients over 30 years. The physician was instructed to discuss the questionnaire with the patient and to ask him about sexual problems. A total of 1,191 physicians took part in the study that documented a total of 10,622 consultations with an average duration of 15 minutes.

RESULTS

The main results were: (i) the patient questionnaire found a high level of acceptance and 54% of discussions of sexual health were prompted by it; (ii) the patients' reaction to physicians addressing sexual health was positive in more than two-thirds of the sample and characterized by openness, willingness to communicate, and relief that their sexual problems had been addressed; (iii) from the physicians' perspective, the most favored communication strategies were a clear signaling of a willingness to talk, and addressing treatment possibilities or signaling that help was available; and (iv) the resulting discussion led to further diagnostic measures in 25% of patients and to further therapeutic measures in 60% of patients.

CONCLUSIONS

There are good grounds for concluding that: (i) addressing a patient's sexual health as part of a physician's everyday routine is feasible in terms of duration and content; and (ii) a short patient questionnaire is an excellent aid for patients and physicians for initiating communication on the topic.

摘要

引言

勃起功能障碍是普遍存在但诊断不足和治疗不充分的健康问题。患者与医生之间的沟通障碍是造成这种情况的主要原因之一,也是性功能障碍报告率低的原因。

目的

本研究的主要目的是调查哪种措辞和沟通策略最能得到医生及其患者的认可,并被认为是最有效的。

主要观察指标

一份记录表格,参与研究的医生对每次会诊进行评分。

方法

要求一大组医生向所有30岁以上的男性患者发放一份简短的患者问卷。医生被要求与患者讨论问卷,并询问其性问题。共有1191名医生参与了这项研究,共记录了10622次会诊,平均时长为15分钟。

结果

主要结果如下:(i)患者问卷得到了高度认可,54%的性健康讨论由此引发;(ii)超过三分之二的样本中,患者对医生提及性健康的反应是积极的,表现为开放、愿意沟通,并因性问题得到关注而感到宽慰;(iii)从医生的角度来看,最受欢迎的沟通策略是明确表示愿意交谈,提及治疗可能性或表示有帮助;(iv)由此引发的讨论导致25%的患者采取了进一步的诊断措施,60%的患者采取了进一步的治疗措施。

结论

有充分理由得出以下结论:(i)将患者的性健康作为医生日常工作的一部分来处理,在时长和内容方面都是可行的;(ii)一份简短的患者问卷是帮助患者和医生就该话题展开沟通的极佳工具。

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