Lobo Carroline P, Pfalzgraf Andrea R, Giannetti Vincent, Kanyongo Gibbs
Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh (Ms Lobo); Division of Clinical, Social and Administrative Sciences, Mylan School of Pharmacy (Drs Pfalzgraf and Giannetti) and Department of Educational Statistics, Educational Foundations and Leadership, School of Education (Dr Kanyongo), Duquesne University, Pittsburgh, Pennsylvania. This study was conducted while Ms Lobo was a student at Duquesne University as part of her Master's thesis.
Prim Care Companion CNS Disord. 2014 Oct 9;16(5). doi: 10.4088/PCC.14m01664. eCollection 2014.
Patients with fibromyalgia have reported experiencing discouragement, rejection, suspicion, and stigma during their encounters with health care professionals. The impact of these experiences on health outcomes has not been extensively examined. The aim of this study was to assess fibromyalgia patients' self-reported quality of life (QoL) and pain based on the following: perceptions of physician attitudes, trust in physicians, perceptions of medical professionals, type of treatment, and various demographic variables.
An online survey was advertised in the electronic newsletter of the National Fibromyalgia and Chronic Pain Association and data were collected in February 2013. A new scale was developed to measure patient perceptions of physician attitudes. Patients' trust in physicians, patients' perceptions of medical professionals, and QoL were measured using the following standardized scales: Trust in Physician Scale, Illness Invalidation Inventory (3*I), and Quality of Life Scale-16 (QOLS-16).
The survey resulted in 670 usable responses. The Patient Perceptions of Physician Attitudes Scale showed high internal consistency and convergent validity (Cronbach α = 0.91). Factor analysis of the Trust in Physician scale, 3*I, and QOLS-16 showed a 1-dimensional structure. Invalidation, use of complementary and alternative medicine, income, age, and marital status were significant predictors of QoL (P < .001). Trust in physician, income, education, and number of referrals to health care providers were significant predictors of pain (P < .001).
Invalidation, trust in physician, and use of complementary medicine can have significant impact on QoL and pain in fibromyalgia. Further research in more representative fibromyalgia samples may help confirm findings.
纤维肌痛患者报告称，在与医护人员接触过程中，他们经历了沮丧、被拒、猜疑和污名化。这些经历对健康结果的影响尚未得到广泛研究。本研究的目的是基于以下因素评估纤维肌痛患者自我报告的生活质量（QoL）和疼痛情况：对医生态度的看法、对医生的信任、对医疗专业人员的看法、治疗类型以及各种人口统计学变量。
在全国纤维肌痛和慢性疼痛协会的电子通讯中刊登了一项在线调查广告，并于2013年2月收集数据。开发了一个新量表来衡量患者对医生态度的看法。使用以下标准化量表测量患者对医生的信任、患者对医疗专业人员的看法以及生活质量：医生信任量表、疾病无效化量表（3*I）和生活质量量表-16（QOLS-16）。
该调查共获得670份可用回复。患者对医生态度看法量表显示出较高的内部一致性和收敛效度（Cronbach α = 0.91）。对医生信任量表、3*I和QOLS-16的因子分析显示为一维结构。无效化、补充和替代医学的使用、收入、年龄和婚姻状况是生活质量的显著预测因素（P <.001）。对医生的信任、收入、教育程度以及转介给医疗服务提供者的次数是疼痛的显著预测因素（P <.001）。
无效化、对医生的信任以及补充医学的使用可能对纤维肌痛患者的生活质量和疼痛产生重大影响。对更具代表性的纤维肌痛样本进行进一步研究可能有助于证实研究结果。
