Arora Neeraj K, Gustafson David H
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-7344, USA.
J Gen Intern Med. 2009 Feb;24(2):252-5. doi: 10.1007/s11606-008-0880-x. Epub 2008 Dec 17.
We evaluated the association between physicians' communication behavior and breast cancer patients' trust in their physicians.
Longitudinal survey conducted at baseline, 2-month, and 5-month follow-up during first year of diagnosis.
Newly diagnosed breast cancer patients (N = 246).
We collected data on patient perceptions of the helpfulness of informational, emotional, and decision-making support provided by physicians and patients' trust. Linear regression models evaluated the association of concurrent and prior levels of physician support with patients' trust.
At baseline, patients who received helpful informational, emotional, and decision-making support from physicians reported greater trust (p < 0.05, p < 0.001, and p < 0.01, respectively). At the 2-month assessment, baseline informational support and informational and emotional support at 2-months were associated with greater trust (p < 0.05, p < 0.01, and p < 0.05, respectively). At the 5-month assessment, only helpful emotional support from physicians at 5 months was associated with greater trust (p < 0.01). Interestingly, while perceived helpfulness of all three types of physician support decreased significantly over time, patient trust remained high and unchanged.
Findings suggest that while informational and decision-making support may be more important to patient trust early in the course of treatment, emotional support from physicians may be important to maintain trust throughout the initial year of diagnosis.
我们评估了医生的沟通行为与乳腺癌患者对其医生的信任之间的关联。
在诊断的第一年,于基线、2个月和5个月随访时进行纵向调查。
新诊断的乳腺癌患者(N = 246)。
我们收集了有关患者对医生提供的信息、情感和决策支持的帮助程度以及患者信任的数据。线性回归模型评估了医生支持的同期和先前水平与患者信任之间的关联。
在基线时,从医生那里获得了有帮助的信息、情感和决策支持的患者报告了更高的信任度(分别为p < 0.05、p < 0.001和p < 0.01)。在2个月的评估中,基线信息支持以及2个月时的信息和情感支持与更高的信任度相关(分别为p < 0.05、p < 0.01和p < 0.05)。在5个月的评估中,只有5个月时医生提供的有帮助的情感支持与更高的信任度相关(p < 0.01)。有趣的是,虽然随着时间的推移,所有三种类型的医生支持的感知帮助程度均显著下降,但患者的信任度仍然很高且没有变化。
研究结果表明,虽然信息和决策支持在治疗早期对患者信任可能更为重要,但医生的情感支持在诊断后的最初一年中对于维持信任可能很重要。