Legg Angela M, Andrews Sara E, Huynh Ho, Ghane Arezou, Tabuenca Arnold, Sweeny Kate
Department of Psychology, Pace University, Pleasantville, NY, USA.
Department of Psychology, University of California, Riverside, Riverside, CA, USA.
Health Expect. 2015 Dec;18(6):3034-43. doi: 10.1111/hex.12288. Epub 2014 Oct 18.
Good patient-provider interactions promote satisfaction with health care, adherence to treatment recommendations and improved health. However, little research has examined patients' emotions and how they relate to patients' experiences with health care and their adherence intentions in acute care settings.
This study examined the predictors and consequences of two emotions pertinent to the uncertainty of acute health-care experiences: anxiety and hopefulness.
Patients who arrived at a general surgery clinic for an initial consultation were interviewed before and after the consultation. Prior to the consultation with a physician, patients completed baseline measures of their emotional state. Following the consultation, patients completed measures of understanding of the information provided by the surgeon, perceived control over treatment decisions, adherence intentions and emotional state.
Understanding and control predicted less anxiety and greater hopefulness, compared to baseline. Only hopefulness predicted adherence intentions. These relationships remained even after controlling for characteristics of the patients and interactions.
These findings identify aspects of psychosocial care that are critical for promoting positive (and mitigating negative) emotional states in patients. Even in a brief consultation in a clinic setting, physicians may be able to improve patients' emotional state by promoting a sense of control and clarifying information they convey, and patients' positive emotional states may be critical for raising adherence intentions.
良好的医患互动可提高患者对医疗保健的满意度、增强对治疗建议的依从性并改善健康状况。然而，很少有研究探讨患者的情绪以及这些情绪如何与患者在急性护理环境中的医疗体验及其依从意图相关。
本研究考察了与急性医疗体验的不确定性相关的两种情绪的预测因素和后果：焦虑和希望。
对到普通外科诊所进行初次咨询的患者在咨询前后进行访谈。在与医生咨询之前，患者完成其情绪状态的基线测量。咨询之后，患者完成对外科医生提供信息的理解、对治疗决策的感知控制、依从意图和情绪状态的测量。
与基线相比，理解和控制可预测焦虑程度降低和希望感增强。只有希望感可预测依从意图。即使在控制了患者特征和互动因素之后，这些关系依然存在。
这些发现确定了心理社会护理中对促进患者积极（并减轻消极）情绪状态至关重要的方面。即使在诊所环境中的简短咨询中，医生也可以通过增强控制感和澄清所传达的信息来改善患者的情绪状态，而患者的积极情绪状态可能对提高依从意图至关重要。
