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患者及其医生的期望与满意度:一致性与差异

Expectations and Level of Satisfaction of Patients and Their Physicians: Concordance and Discrepancies.

作者信息

Goldzweig Gil, Abramovitch Amitai, Brenner Baruch, Perry Shlomit, Peretz Tamar, Baider Lea

机构信息

School of Behavioral Sciences, The Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel (GG).

OCD and Related Disorders Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA (AA).

出版信息

Psychosomatics. 2015 Sep-Oct;56(5):521-9. doi: 10.1016/j.psym.2014.10.001. Epub 2014 Oct 5.

Abstract

BACKGROUND

Identifying discrepancies between patients׳ expectations for support provided by their physicians, and physicians׳ appraisal of the support they provide to their patients, is a key factor in constructing effective doctor-patient communication.

OBJECTIVE

The current study proposes and explores a paradigm for assessing possible gaps and overlaps between perceptions of patients with cancer and physicians about the "actual" and the "ideal" (desired) emotional and cognitive support oncologists provide to patients.

METHODS

Participants included 1027 patients with cancer and 47 senior oncologists. Patients׳ and physicians׳ levels of expectations and satisfaction with the emotional and cognitive support offered by physicians were assessed using a quantitative measure of discrepancy between the actual and the ideal situation. The measure was developed for this study and tested on a random sample of 200 patients and 17 oncologists.

RESULTS

The results indicated consistency between physicians׳ and patients׳ perceptions of the needs and support that the patients received. Nevertheless, oncologists did not feel highly trusted by their patients, oncologists desired less involvement of patients in the treatment plan than the patients expected. Oncologists thought that they actually provided the desired levels of explanation to patients׳ families, whereas patients thought their families got less explanations than expected.

CONCLUSION

Actual and ideal levels of communication should be described from the points of view of both physicians and patients to better understand the complex picture of patient satisfaction. Oncologists should consider patients׳ expectations for support vs their own expectations to effectively address patients׳ needs.

摘要

背景

识别患者对医生提供支持的期望与医生对其向患者提供支持的评估之间的差异,是构建有效的医患沟通的关键因素。

目的

本研究提出并探索一种范式,以评估癌症患者与医生对肿瘤学家为患者提供的“实际”和“理想”(期望)情感及认知支持的认知之间可能存在的差距和重叠。

方法

参与者包括1027名癌症患者和47名资深肿瘤学家。使用实际情况与理想情况之间差异的定量测量方法,评估患者和医生对医生提供的情感及认知支持的期望水平和满意度。该测量方法是为本研究开发的,并在200名患者和17名肿瘤学家的随机样本上进行了测试。

结果

结果表明,医生和患者对患者所接受的需求和支持的认知一致。然而,肿瘤学家并未感到患者对他们高度信任,肿瘤学家期望患者在治疗计划中的参与度低于患者的预期。肿瘤学家认为他们实际上向患者家属提供了期望的解释水平,而患者认为他们的家属得到的解释比预期少。

结论

应从医生和患者的角度描述实际和理想的沟通水平,以更好地理解患者满意度的复杂情况。肿瘤学家应考虑患者对支持的期望与他们自己的期望,以有效满足患者的需求。

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