National Center for Primary Care, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Dr, Atlanta, GA 30310, USA.
J Natl Med Assoc. 2010 Dec;102(12):1237-42. doi: 10.1016/s0027-9684(15)30779-3.
We sought to gain a better understanding of the relationship between patients' serious psychological distress (SPD) and their perception of interactions with health care providers and their ratings of the health care quality.
We analyzed data from 6286 adult respondents to the 2007 Health Information National Trends Survey. We conducted cross-tabulations to compare sociodemographic characteristics between those with SPD and those without SPD. Using odds ratios and 95% confidence intervals from logistic regression models, we assessed the association between psychological status and indicators of perceived health care communication and the overall health care quality after controlling for sociodemographic variables.
Patients with SPD were less likely to report that their provider "always" paid attention to their feelings and emotions, "always" ensured their understanding of the needed care, and "always" assisted them dealing with uncertain feelings. These distressed patients were also less satisfied with the overall health care quality.
Patients' psychological distress is negatively associated with their perceived quality of communication with health providers. Further knowledge on the health care need of patients with SPD would be important in improving health service delivery and optimizing the psychological care of medical patients.
我们试图更好地理解患者严重心理困扰(SPD)与其对与医疗保健提供者互动的感知以及对医疗质量的评价之间的关系。
我们分析了 2007 年健康信息国家趋势调查中 6286 名成年受访者的数据。我们进行了交叉表分析,比较了有 SPD 和没有 SPD 的患者的社会人口统计学特征。使用逻辑回归模型中的优势比和 95%置信区间,在控制社会人口统计学变量后,评估了心理状态与感知医疗保健沟通指标和整体医疗保健质量之间的关联。
有 SPD 的患者不太可能报告他们的提供者“总是”关注他们的感受和情绪,“总是”确保他们理解所需的护理,“总是”帮助他们应对不确定的感受。这些感到困扰的患者对整体医疗保健质量也不太满意。
患者的心理困扰与他们对与医疗保健提供者沟通质量的感知呈负相关。进一步了解 SPD 患者的医疗保健需求对于改善医疗服务提供和优化医疗患者的心理护理非常重要。