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情感距离和保留在健康研究患者、良性乳腺疾病和乳腺癌患者医患沟通中的作用:芬兰一项前瞻性病例对照研究。

Contribution of emotional distance and reserve in patient-physician communication in healthy study patients, and in patients with benign breast disease and breast cancer: a prospective case-control study in Finland.

机构信息

Department of Surgery, Kuopio University Hospital, PL 1777, 70211 Kuopio, Finland.

出版信息

Anticancer Res. 2014 Mar;34(3):1269-74.

Abstract

AIM

Emotionally-restricted and 'poor-understanding'communication between a patient and their physician may be associated with difficulties in diagnosis and with poor treatment results in clinical practice. To our knowledge, the associations between distance and reserve in patient-physician communication and the risk of breast cancer (BC) are rarely considered together in a prospective study.

PATIENTS AND METHODS

In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated for emotional distance and reservation in patient-physician communication before any diagnostic procedures were carried out.

RESULTS

Clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, while 28 individuals were shown to be healthy (HSS). There was a trend for the BC group to report more emotional distance in patient-physician communication (30/34, 89.0%; grade I to IV emotional distance) than the patients in the HSS and BBD groups (78.6% and 75.5%, grade I to IV emotional distance, respectively). However, the mean of the distance score for HSS, BBD and BC groups differed only slightly in grade II and grade III. The BC group had a higher ERS emotional reservation score in contact (25/34, 73.5%; grade I to IV reserve) than the patients in the HSS and BBD groups (57.1% and 62.1%, grade I to IV reserve, respectively). However, the mean of the reserve score for HSS, BBD and BC groups differed only slightly in grade II, grade III and grade IV.

CONCLUSION

The results of this study showed that patients with BC could be at risk for emotional distance and reserve in patient-physician communication and this should be taken into account in the relationship between the patient and their physician and may have clinical relevance in day-to-day clinical work.

摘要

目的

患者与医生之间情感受限和“理解不足”的沟通可能与临床实践中的诊断困难和治疗效果不佳有关。据我们所知,在前瞻性研究中,很少将患者-医生沟通中的距离和保留与乳腺癌(BC)风险联系起来考虑。

患者和方法

在库奥皮奥乳腺癌研究的扩展中,在进行任何诊断程序之前,对 115 名有乳房症状的女性进行了患者-医生沟通中的情绪距离和保留评估。

结果

临床检查和活检显示 34 名患者患有 BC,53 名患者患有良性乳腺疾病(BBD),28 名患者健康(HSS)。BC 组报告在患者-医生沟通中存在更多情感距离的趋势(30/34,89.0%;I 至 IV 级情感距离),而 HSS 和 BBD 组的患者分别为 78.6%和 75.5%(I 至 IV 级情感距离)。然而,HSS、BBD 和 BC 组的距离评分均值在 II 级和 III 级仅略有不同。BC 组在接触时的 ERS 情感保留评分较高(25/34,73.5%;I 至 IV 级保留),而 HSS 和 BBD 组的患者分别为 57.1%和 62.1%(I 至 IV 级保留)。然而,HSS、BBD 和 BC 组的保留评分均值在 II 级、III 级和 IV 级仅略有不同。

结论

本研究结果表明,BC 患者可能存在患者-医生沟通中的情感距离和保留风险,这在医患关系中应予以考虑,并且可能对日常临床工作具有临床相关性。

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