Wu Heng, Zhao Xudong, Fritzsche Kurt, Leonhart Rainer, Schaefert Rainer, Sun Xiayuan, Larisch Astrid
Department of Psychosomatic Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Psychosomatic Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Complement Ther Med. 2015 Feb;23(1):23-31. doi: 10.1016/j.ctim.2014.12.006. Epub 2015 Jan 4.
High somatic symptom severity (SSS) is associated with reduced health-related function and may affect doctor-patient interactions. This study aimed to explore the quality of the doctor-patient relationship (DPR) and its association with SSS in Chinese general hospitals outpatients.
This multicenter cross-sectional study assessed the quality of DPR from both the doctor's and patient's perspective in general outpatients (n=484) from 10 departments of Psychosomatic Medicine (PM), Traditional Chinese Medicine (TCM), and Biomedicine (BM). SSS was assessed with the PHQ-15. The quality of the DPR was measured with the CARE, PDRQ-9, and DDPRQ-10 questionnaires. In addition, several standard instruments were used to assess psychosocial variables such as depression, anxiety, sense of coherence and quality of life.
From the doctor's perspective, patients with high SSS were rated as significantly more difficult than patients with low SSS. No differences were noted from the perspective of the patients. Patients from the TCM department rated the quality of their DPR significantly higher than those in BM and PM and were rated from doctor's perspective as less difficult than those in BM and PM. Multiple regression analysis revealed satisfaction of treatment, time of treatment and psychosocial variables, such as age, health related anxiety, depression, mental quality of life and sense of coherence as predictors for DPR.
PM and BM departments should learn from TCM departments to be empathic, to manage patients with high SSS and to establish long-term relationships with their patients.
高躯体症状严重程度（SSS）与健康相关功能下降有关，可能会影响医患互动。本研究旨在探讨中国综合医院门诊患者的医患关系质量（DPR）及其与SSS的关联。
这项多中心横断面研究从医生和患者的角度评估了来自心身医学（PM）、中医（TCM）和生物医学（BM）10个科室的普通门诊患者（n = 484）的DPR质量。使用PHQ - 15评估SSS。使用CARE、PDRQ - 9和DDPRQ - 10问卷测量DPR质量。此外，还使用了几种标准工具来评估心理社会变量，如抑郁、焦虑、连贯感和生活质量。
从医生的角度来看，高SSS患者的评分明显比低SSS患者更难相处。从患者的角度来看，未发现差异。中医科室的患者对其DPR质量的评分明显高于BM和PM科室的患者，从医生的角度来看，中医科室患者比BM和PM科室的患者更不难相处。多元回归分析显示，治疗满意度、治疗时间以及心理社会变量，如年龄、健康相关焦虑、抑郁、心理生活质量和连贯感是DPR的预测因素。
PM和BM科室应向中医科室学习，要有同理心，管理高SSS患者，并与患者建立长期关系。
