San Inazio Health Care Centre, Osakidetza/Basque Health Service, Bilbao, Spain.
BMC Fam Pract. 2009 Nov 25;10:73. doi: 10.1186/1471-2296-10-73.
A new intervention aimed at managing patients with medically unexplained symptoms (MUS) based on a specific set of communication techniques was developed, and tested in a cluster randomised clinical trial. Due to the modest results obtained and in order to improve our intervention we need to know the GPs' attitudes towards patients with MUS, their experience, expectations and the utility of the communication techniques we proposed and the feasibility of implementing them. Physicians who took part in 2 different training programs and in a randomised controlled trial (RCT) for patients with MUS were questioned to ascertain the reasons for the doctors' participation in the trial and the attitudes, experiences and expectations of GPs about the intervention.
A qualitative study based on four focus groups with GPs who took part in a RCT. A content analysis was carried out.
Following the RCT patients are perceived as true suffering persons, and the relationship with them has improved in GPs of both groups. GPs mostly valued the fact that it is highly structured, that it made possible a more comfortable relationship and that it could be applied to a broad spectrum of patients with psychosocial problems. Nevertheless, all participants consider that change in patients is necessary; GPs in the intervention group remarked that that is extremely difficult to achieve.
GPs positively evaluate the communication techniques and the interventions that help in understanding patient suffering, and express the enormous difficulties in handling change in patients. These findings provide information on the direction in which efforts for improving intervention should be directed.
US ClinicalTrials.gov NCT00130988.
为了管理患有医学无法解释症状（MUS）的患者，我们开发了一种新的干预措施，该措施基于一套特定的沟通技巧，并在一项集群随机临床试验中进行了测试。由于结果不太理想，为了改进我们的干预措施，我们需要了解全科医生对 MUS 患者的态度、他们的经验、期望以及我们提出的沟通技巧的实用性，以及实施这些技巧的可行性。我们对参加了两项不同培训计划和 MUS 患者随机对照试验（RCT）的全科医生进行了调查，以确定医生参与试验的原因，以及全科医生对干预措施的态度、经验和期望。
这是一项基于参加 RCT 的全科医生的四个焦点小组的定性研究。我们进行了内容分析。
在 RCT 之后，患者被视为真正受苦的人，并且两组全科医生与他们的关系都得到了改善。全科医生大多看重该干预措施高度结构化、使医患关系更加舒适以及可以适用于具有社会心理问题的广泛患者的特点。然而，所有参与者都认为患者的改变是必要的；干预组的全科医生指出，这是极其困难的。
全科医生对有助于理解患者痛苦的沟通技巧和干预措施给予了积极评价，并表达了在处理患者变化方面的巨大困难。这些发现为改进干预措施的方向提供了信息。
美国临床试验.gov NCT00130988。
