Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Patient Educ Couns. 2013 Mar;90(3):354-60. doi: 10.1016/j.pec.2011.02.014. Epub 2011 Apr 8.
To study doctor-patient interaction styles in consultations with patients presenting persistent medically unexplained symptoms (MUS) and to study on which stages of the consultation patients and doctors focus within the available time.
exploratory, qualitative analysis of transcripts of 20 videotaped consultations between family physicians (FP) and persistent MUS patients.
Patients presented many symptoms in a rather unstructured way. However, FPs hardly used structuring techniques such as agenda setting and summarizing. Patients with persistent MUS got much opportunity to tell their story, but the reasons for encounter, their beliefs and concerns were not discussed in a structured manner. Although consultations were focused on these issues, mostly patients themselves initiated discussion of their ideas, concerns and expectations. FPs' extensive explanations of the origin of the symptoms often did not take patients' beliefs and concerns into account.
Due to patients' multiple symptom presentation and the absence of FPs' structuring techniques, consultations of persistent MUS patients proceed rather unfocused. However, patients got ample opportunity to tell their story.
Persistent MUS patients might benefit from structured consultations focused on the exploration of the reason for encounter.
研究在持续性医学无法解释症状（MUS）患者就诊中医生-患者的互动方式，并研究患者和医生在可用时间内关注咨询的哪些阶段。
对家庭医生（FP）与持续性 MUS 患者的 20 次录像咨询的记录进行探索性、定性分析。
患者以相当不规范的方式呈现出许多症状。然而，FP 几乎没有使用结构技术，如设定议程和总结。持续性 MUS 患者有很多机会讲述自己的故事，但遭遇的原因、他们的信念和担忧没有以结构化的方式进行讨论。尽管咨询集中在这些问题上，但主要是患者自己主动讨论他们的想法、担忧和期望。FP 对症状起源的广泛解释往往没有考虑到患者的信念和担忧。
由于患者的多种症状表现和 FP 缺乏结构技术，持续性 MUS 患者的咨询过程较为不集中。然而，患者有充分的机会讲述自己的故事。
持续性 MUS 患者可能受益于重点关注就诊原因的结构化咨询。
