Fröjd Camilla, Lampic Claudia, Larsson Gunnel, von Essen Louise
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Scand J Caring Sci. 2009 Mar;23(1):107-16. doi: 10.1111/j.1471-6712.2008.00596.x.
The aim of this study was to investigate (i) whether specific aspects of the initial consultation (IC) and/or patients' satisfaction with doctors' care are related to health-related quality of life (HRQoL), anxiety and depression among patients with carcinoid tumours and (ii) whether patients' satisfaction with doctors' care changes over time. The study has a longitudinal design. The HRQoL and psychosocial function among patients who met the doctors showing good ability to identify patients' worry and wish for information were compared with those patients who met doctors showing less good ability. Patients' HRQoL, anxiety, depression and satisfaction with doctors' care were assessed longitudinally, shortly after each of the first four admissions to specialist care. Patients who met doctors showing good ability to identify their wish for information at the IC reported higher levels of cognitive function. Higher satisfaction with doctors' care was related to higher emotional and cognitive function, to higher global QoL, and to lower levels of problems with diarrhoea, financial difficulties, constipation, anxiety and depression shortly after each of the first three admissions, although not after the fourth admission to the specialist care. Although most patients with carcinoid tumours report high satisfaction with care, it is important to be aware of the fact that some patients may be less satisfied. Doctors should provide patients with information which matches the individual patients' needs and preferences as patients' satisfaction with doctors' provision of information is related to patients' HRQoL, anxiety and depression.
(i)初次咨询(IC)的特定方面和/或患者对医生护理的满意度是否与类癌肿瘤患者的健康相关生活质量(HRQoL)、焦虑和抑郁有关;以及(ii)患者对医生护理的满意度是否随时间变化。该研究采用纵向设计。将那些见到的医生表现出良好识别患者担忧和信息需求能力的患者的HRQoL和心理社会功能,与那些见到的医生能力稍逊的患者进行比较。在首次四次专科护理入院后不久,纵向评估患者的HRQoL、焦虑、抑郁以及对医生护理的满意度。在初次咨询时见到的医生表现出良好识别其信息需求能力的患者,报告的认知功能水平更高。在首次三次入院后不久,对医生护理更高的满意度与更高的情绪和认知功能、更高的总体生活质量以及更低水平的腹泻问题、经济困难、便秘、焦虑和抑郁相关,但在第四次专科护理入院后则不然。尽管大多数类癌肿瘤患者对护理报告高度满意,但必须意识到有些患者可能满意度较低。由于患者对医生提供信息的满意度与患者的HRQoL、焦虑和抑郁相关,医生应向患者提供符合个体患者需求和偏好的信息。