Gilliam Frank, Penovich Patricia E, Eagan Corey A, Stern John M, Labiner David M, Onofrey Meaghan, Holmes Gregory L, Mathis Eileen, Cramer Joyce
Comprehensive Epilepsy Center, Cornell University, New York, NY, USA.
Epilepsy Behav. 2009 Oct;16(2):315-20. doi: 10.1016/j.yebeh.2009.07.039. Epub 2009 Aug 31.
An in-office linguistic study was conducted to assess neurologist-patient discussions of epilepsy. Naturally occurring interactions among 20 neurologists and 60 of their patients with epilepsy were recorded. Participants were interviewed separately postvisit. Transcripts were analyzed using sociolinguistic techniques. Of 59 patients taking antiepileptic drugs previsit, 44 (75%) discussed side effects with their neurologist. Side effect discussions were most often neurologist initiated. Postvisit, patients and neurologists often disagreed about which side effects were experienced. The presence of a caregiver (e.g., spouse) usually resulted in lengthier, more detailed discussions of side effects, without drastically increasing overall visit length. Discussions of mood- and behavior-related comorbidities occurred infrequently (14 of 60 visits); postvisit, neurologists stated that they felt that management of these conditions was outside their area of expertise. Communication gaps observed in discussions of epilepsy and its treatment warrant further exploration. Additional research is currently underway to assess the efficacy of a previsit assessment tool.
开展了一项门诊语言研究，以评估神经科医生与患者关于癫痫的讨论情况。记录了20名神经科医生及其60名癫痫患者之间自然发生的互动。参与者在就诊后分别接受访谈。使用社会语言学技术对访谈记录进行分析。在就诊前服用抗癫痫药物的59名患者中，44名（75%）与神经科医生讨论了副作用。副作用的讨论大多由神经科医生发起。就诊后，患者和神经科医生经常在经历了哪些副作用的问题上存在分歧。有护理人员（如配偶）在场通常会导致对副作用的讨论更冗长、更详细，但不会大幅增加就诊总时长。关于情绪和行为相关合并症的讨论很少发生（60次就诊中有14次）；就诊后，神经科医生表示他们认为这些病症的管理超出了他们的专业领域。在癫痫及其治疗的讨论中观察到的沟通差距值得进一步探究。目前正在进行额外研究，以评估就诊前评估工具的效果。
