Davis Jamie D, Engel Charles C, Mishkind Matthew, Jaffer Ambereen, Sjoberg Terry, Tinker Tim, McGough Martin, Tipton Stacia, Armstrong David, O'Leary Timothy
Deployment Health Clinical Center, Walter Reed Army Medical Center, Washington, DC, USA.
Patient Educ Couns. 2007 Sep;68(1):52-60. doi: 10.1016/j.pec.2007.04.007. Epub 2007 May 29.
To gain insight about Department of Defense providers' and health care beneficiaries' opinions regarding provider-patient communication of health care for post-deployment health concerns.
Thirty-five Department of Defense primary care providers and 14 military beneficiaries participated in focus groups at five military medical treatment facilities. We audiotaped, transcribed, and qualitatively analyzed semi-structured focus group interviews to determine attitudes and beliefs about war-related health concerns, symptoms, and health care quality.
Focus groups revealed important insights about provider and patient perspectives of communication and care in four general areas: physician-patient trust, validity of symptoms and concerns, exchange of health information, and barriers to care.
Provider-patient communication contributes to patient satisfaction with medical care; poor communication may contribute to decreased patient satisfaction and provider effectiveness. The military health care system poses several challenges to provider-patient communication: the dual nature of the provider's role, the occupational relationship between illness and health care, pre- and post-deployment issues, and continuity of care impact patient and provider perspectives. The prevalence of various beneficiary and provider concerns regarding health care communication requires further study, particularly for the severely wounded.
The quality of information exchanged and of the interpersonal relationship impact medical decision making, particularly in occupational health settings such as the military. Attention to these issues may improve patient outcomes including satisfaction, adherence, trust, health status, and quality of life.
深入了解国防部医疗服务提供者及医疗保健受益者对于部署后健康问题的医疗服务中提供者与患者沟通的看法。
35名国防部初级保健提供者和14名军事受益者参与了在五个军事医疗设施进行的焦点小组讨论。我们对这些半结构化焦点小组访谈进行了录音、转录和定性分析,以确定对与战争相关的健康问题、症状及医疗服务质量的态度和信念。
焦点小组讨论揭示了在四个总体领域中提供者和患者对沟通及护理的看法的重要见解:医患信任、症状及担忧的有效性、健康信息交流以及护理障碍。
医患沟通有助于患者对医疗服务的满意度;沟通不畅可能导致患者满意度下降及提供者效率降低。军事医疗系统给医患沟通带来了若干挑战:提供者角色的双重性质、疾病与医疗服务之间的职业关系、部署前后的问题以及护理连续性影响患者和提供者的看法。各种受益者和提供者对医疗保健沟通的担忧普遍存在,需要进一步研究,尤其是对于重伤员。
所交换信息的质量及人际关系会影响医疗决策,特别是在军事等职业健康环境中。关注这些问题可能改善患者的治疗效果,包括满意度、依从性、信任度、健康状况及生活质量。