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患者和医患关系特征对健康相关生活质量沟通的影响。

Effect of patient and patient-oncologist relationship characteristics on communication about health-related quality of life.

机构信息

Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.

出版信息

Psychooncology. 2011 Sep;20(9):935-42. doi: 10.1002/pon.1829. Epub 2010 Aug 25.

Abstract

OBJECTIVE

To test the effects of patient and patient-oncologist relationship factors on the time spent communicating about health-related quality of life (HRQOL) during outpatient clinic encounters between oncologists and their patients with advanced cancer.

METHODS

Using mixed methods, we coded for duration of HRQOL talk in a subset of audio-recorded conversations from the Study of Communication in Oncologist-Patient Encounters (SCOPE) Trial. Multivariable linear regression modeling was used to investigate the relationship between duration of HRQOL talk and gender concordance, race concordance, patient education status, patient marital status, and length of the patient-oncologist relationship (i.e. number of previous visits).

RESULTS

Sixty-six encounters were analyzed that involved 63 patients and 34 oncologists. Patients were more likely to be female (51%), white (86%), married (78%), and possess a college or more advanced degree (33%). Most oncologists were male (82%) and white (82%). Mean ages were 58.8 years for patients and 44.9 years for oncologists. Regression results showed that the number of a patient's previous visits with their oncologist was significantly associated with a longer duration of HRQOL talk during their audio-recorded clinic visit. The remaining independent variables, gender concordance, race concordance, patient education status, and patient marital status were not significant predictors of duration of HRQOL talk.

CONCLUSIONS

Our findings suggest that length of the patient-oncologist relationship is related to duration of HRQOL talk. Improvements in HRQOL communication may best be achieved through efforts directed at those in earlier stages of the doctor-patient relationship.

摘要

目的

测试医患关系因素对肿瘤学家与晚期癌症患者门诊就诊时沟通健康相关生活质量(HRQOL)时间的影响。

方法

使用混合方法,我们对来自肿瘤学家-患者互动研究(SCOPE)试验的一部分录音对话中的 HRQOL 谈话时间进行了编码。使用多变量线性回归模型研究了 HRQOL 谈话时间与性别一致性、种族一致性、患者教育状况、患者婚姻状况和医患关系长度(即之前就诊次数)之间的关系。

结果

共分析了 66 次就诊,涉及 63 名患者和 34 名肿瘤学家。患者更可能是女性(51%)、白人(86%)、已婚(78%)和拥有大学或更高学历(33%)。大多数肿瘤学家是男性(82%)和白人(82%)。患者的平均年龄为 58.8 岁,肿瘤学家的平均年龄为 44.9 岁。回归结果表明,患者与肿瘤学家之前就诊次数与他们在录音门诊就诊期间 HRQOL 谈话时间的长短显著相关。其余的独立变量,性别一致性、种族一致性、患者教育状况和患者婚姻状况与 HRQOL 谈话时间的长短无关。

结论

我们的研究结果表明,医患关系的长度与 HRQOL 谈话时间有关。改善 HRQOL 沟通可能最好通过努力实现,这些努力应针对医生与患者关系的早期阶段。

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