Department of Rheumatology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
Patient Educ Couns. 2009 Jul;76(1):57-62. doi: 10.1016/j.pec.2008.11.011. Epub 2008 Dec 31.
To describe nurse-patient and rheumatologist-patient interaction in fatigue communication at the rheumatology out-patient clinic.
Consultations of 20 rheumatoid arthritis (RA) patients with the nurse specialist and the rheumatologist were videotaped and analysed using the Medical Interview Aural Rating Scale (MIARS). Subsequently, patients were asked to fill out a concern questionnaire asking how worried they felt and how satisfied they were with attention given by both healthcare professionals. Finally, patients were interviewed on reasons for being not or not completely satisfied with the care received.
Fatigue was discussed in 42% of the rheumatologists' consultations and 83% of the nurse specialists' consultations. RA patients more often used implicit cues instead of explicit concerns related to fatigue. Almost 72% of the patients felt worried about fatigue and in general they were more satisfied with the nurse specialist's attention to fatigue than with the attention from the rheumatologist.
Fatigue is not structurally communicated at the rheumatology out-patient clinic and exploring and acknowledging communication techniques can help patients to express their concerns about fatigue.
Healthcare professionals must recognise fatigue as a severe problem for RA patients and start the conversation on fatigue instead of waiting for the patient to mention fatigue spontaneously.
描述在风湿病门诊中护士-患者和风湿病医生-患者在疲劳沟通中的互动。
对 20 名类风湿关节炎（RA）患者与护士专家和风湿病医生的咨询进行录像，并使用医疗访谈听觉评分量表（MIARS）进行分析。随后，患者填写了一份关注问卷，询问他们对两位医护人员的关注感到担忧和满意的程度。最后，对患者进行了有关对所接受的护理不满意或不完全满意的原因的访谈。
疲劳在 42%的风湿病医生的咨询和 83%的护士专家的咨询中进行了讨论。RA 患者更多地使用暗示性而非明确的与疲劳相关的线索。将近 72%的患者对疲劳感到担忧，总体而言，他们对护士专家对疲劳的关注比对风湿病医生的关注更满意。
风湿病门诊并未系统地传达疲劳问题，探索和承认沟通技巧可以帮助患者表达对疲劳的关注。
医疗保健专业人员必须认识到疲劳是 RA 患者的严重问题，并开始就疲劳问题进行对话，而不是等待患者主动提及疲劳。
