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抑郁对西班牙裔终末期肾病患者医患沟通的影响。

The effect of depression on physician-patient communication among Hispanic end-stage renal disease patients.

机构信息

Department of Psychology, School of Behavioral and Organizational Sciences, Claremont Graduate University, Claremont, California, USA.

出版信息

J Health Commun. 2013;18(5):485-97. doi: 10.1080/10810730.2012.727962. Epub 2013 Feb 14.

Abstract

End-stage renal disease is associated with increased level of depression. Depression is associated with a reduction in the ability of people to effectively communicate in interpersonal settings. The interaction between end-stage renal disease patients and their physicians has important implications for the course of the treatment of this disease; however, there is limited research examining the influence of depression on general patient-physician communication. This study examines the association between depression and physician-patient communication in a sample of Hispanic end-stage renal disease patients. Participating patients filled out the Beck Depression Inventory and self-reported their feelings about meeting with physicians. Patients then met with a physician, and a nurse practitioner observed the interaction. Results indicate that depression was negatively associated with patients' self-reported perceptions of their readiness for the appointment (r =-.20) and with self-reported communication efficacy (r =-.19). Moreover, the nurse practitioner rated patients with depression as being significantly less likely (a) to ask for clarification (r =-.40), (b) to be engaged in the conversation (r =-.46), and (c) to be forthcoming with the physician (r =-.37). Results of this study have significant implications for communication between physicians and end-stage renal disease patients and for the influence of depression on patient-physician communication.

摘要

终末期肾病与抑郁水平升高有关。抑郁与人们在人际交往环境中有效沟通的能力下降有关。终末期肾病患者与医生之间的互动对该疾病的治疗过程有重要影响;然而,目前关于抑郁对一般医患沟通影响的研究有限。本研究在一组西班牙裔终末期肾病患者中考察了抑郁与医患沟通之间的关系。参与研究的患者填写了贝克抑郁量表,并自我报告了他们对与医生见面的感受。然后,患者与医生见面,护士从业者观察互动情况。结果表明,抑郁与患者对预约准备情况的自我报告感知(r = -.20)和自我报告的沟通效果(r = -.19)呈负相关。此外,护士从业者认为患有抑郁症的患者(a)要求澄清的可能性显著降低(r = -.40),(b)参与对话的可能性显著降低(r = -.46),以及(c)与医生坦诚相待的可能性显著降低(r = -.37)。本研究结果对医生与终末期肾病患者之间的沟通以及抑郁对医患沟通的影响具有重要意义。

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