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多发性硬化症诊断的沟通——一项定性研究

Communicating the diagnosis of multiple sclerosis - a qualitative study.

作者信息

Solari A, Acquarone N, Pucci E, Martinelli V, Marrosu M G, Trojano M, Borreani C, Messmer Uccelli M

机构信息

Neuroepidemiology Unit, C Besta National Neurological Institute, Milan, Italy.

出版信息

Mult Scler. 2007 Jul;13(6):763-9. doi: 10.1177/1352458506074689. Epub 2007 Mar 15.

Abstract

Studies on communicating the diagnosis of multiple sclerosis (MS) are few, and all reveal communication and information deficits. We explored the personal experience of diagnosis communication of people with MS and health professionals, using a qualitative methodology. Data were obtained from two sets of focus group meetings (FGM) with people with MS (total 23; 16 females; age range: 23-70) and one FGMs with health professionals (four neurologists, three psychologists, two nurses). The methods of framework analysis were applied to meeting transcripts to identify key topics and categories. The experience of communicating/receiving an MS diagnosis was highly varied; all patients reported the moment as powerfully evocative and unforgettable. Very poor levels of support and information were sometimes given. Although diagnosis communication had improved in more recent experience, all felt it should be further improved with appropriate setting (privacy, no interruptions, sufficient time), information tailored to the individual, and continuity of care. Such improvements imply a more meaningful patientneurologist relationship, and also structural and organisational changes.

摘要

关于多发性硬化症(MS)诊断告知的研究较少,且所有研究均揭示了沟通和信息方面的不足。我们采用定性研究方法,探究了MS患者和医疗专业人员在诊断沟通方面的个人经历。数据来自两组与MS患者的焦点小组会议(FGM)(共23人;16名女性;年龄范围:23 - 70岁)以及一组与医疗专业人员的FGM(四名神经科医生、三名心理学家、两名护士)。运用框架分析方法对会议记录进行分析,以确定关键主题和类别。传达/接收MS诊断的经历差异很大;所有患者都表示这一时刻令人印象深刻且难以忘怀。有时提供的支持和信息水平极低。尽管近期的诊断沟通有所改善,但所有人都认为应通过合适的环境(隐私、无干扰、足够时间)、针对个体的信息以及持续护理进一步加以改进。这些改进意味着医患关系更有意义,同时也需要结构和组织上的变革。

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