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恶性淋巴瘤患者在确诊后的各个阶段经历的有效沟通的障碍和促进因素。

Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis.

机构信息

NIVEL, Utrecht, The Netherlands.

出版信息

Psychooncology. 2013 Dec;22(12):2807-14. doi: 10.1002/pon.3352. Epub 2013 Jul 29.

Abstract

OBJECTIVE

This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly.

METHOD

A qualitative approach was applied, derived from the context mapping framework. A total of 28 patients completed a set of assignments about their experiences with provider-patient communication during medical consultations. Subsequently, these patients and nine companions shared their experiences during a semistructured (group) interview, which was recorded on audiotape. The audiotapes and assignments were analysed with MAXQDA software.

RESULTS

From the patients' viewpoint, communicating effectively appears to depend on their own attributes (e.g. emotions), the health care professionals' attributes (e.g. attitude) and external factors (e.g. time pressure). Three patient communication states were identified: (i) overwhelmed, passive; (ii) pro-active, self-motivated; and (iii) proficient, empowered. Patients seem to behave differently in the three communication states.

CONCLUSIONS

This study lists patient-perceived communication barriers and facilitators and identifies three different communication states, which indicate when certain barriers and facilitators are encountered.

PRACTICAL IMPLICATIONS

These findings may support health care professionals to tailor the provision of support and information and remove communication barriers accordingly. Additionally, they provide input for interventions to support patients in effective communication.

摘要

目的

本研究旨在深入了解恶性淋巴瘤诊断后不同阶段患者感知到的沟通障碍和促进因素。我们已经发现了一些模式,可以解释这些因素何时主要影响沟通。

方法

采用源自情境映射框架的定性方法。共有 28 名患者完成了一套关于他们在医疗咨询期间与提供者沟通的体验的任务。随后,这些患者和 9 名同伴在半结构化(小组)访谈中分享了他们的经验,该访谈被录音。使用 MAXQDA 软件对录音带和任务进行分析。

结果

从患者的角度来看,有效的沟通似乎取决于他们自己的属性(例如情绪)、医疗保健专业人员的属性(例如态度)和外部因素(例如时间压力)。确定了三种患者沟通状态:(i)不知所措,被动;(ii)积极主动,自我激励;和(iii)熟练,有能力。患者在这三种沟通状态下似乎表现不同。

结论

本研究列出了患者感知到的沟通障碍和促进因素,并确定了三种不同的沟通状态,表明何时会遇到某些障碍和促进因素。

实用意义

这些发现可以支持医疗保健专业人员根据需要调整支持和信息的提供,并相应消除沟通障碍。此外,它们为干预措施提供了投入,以支持患者进行有效的沟通。

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