Lian Olaug S, Hansen Anne Helen
University of Tromsø - The Arctic University of Norway, Norway
University of Tromsø - The Arctic University of Norway, Norway; University Hospital of North Norway, Norway.
Health (London). 2016 May;20(3):308-26. doi: 10.1177/1363459315583158. Epub 2015 May 14.
Bodily conditions that are difficult to identify, explain and treat with the aid of medical knowledge and technology appear to be particularly challenging to medical encounters. Patients are often dissatisfied with the help they receive, and they often experience that their medical needs are not met. To explore factors facilitating patient satisfaction among patients with a medically unexplained condition, we ask: what is the importance of individual versus relational factors in facilitating patient satisfaction in clinical encounters between general practitioners (GPs) and women with medically unexplained long-term fatigue? We approach this question through a statistical analysis of survey data collected from a net sample of 431 women recruited through a patient organisation for people suffering from myalgic encephalomyelitis in 2013. Participants were asked about their experiences with general practitioners in the Norwegian national health system in two different phases: shortly after illness onset, and current regular general practitioner last 12 months. The questions evolved around themes concerning shared understanding and decision making, being taken seriously, being paid due respect and being treated as an equal partner. Through descriptive statistics and multivariable logistic regression analyses, we explored how their experiences were related to individual and relational factors, respectively. Free-text comments from the questionnaires were used while interpreting the results. The analysis illuminates that relational aspects in medical encounters between GPs and ME patients, especially continuity, congruence in doctor-patient views and being seen by a specialist, are important catalysts of patient satisfaction. The probability of being satisfied with the initial investigation was more than six times higher in women who were referred to specialists, compared to those who were not. We conclude that continuity of care and experiences of being in a partnership that operates on a common ground - a shared understanding of the patient's illness - foster patient satisfaction among women with medically unexplained long-term fatigue.
借助医学知识和技术难以识别、解释及治疗的身体状况，似乎给医疗接触带来了特别大的挑战。患者常常对所获得的帮助不满意，且经常觉得自己的医疗需求未得到满足。为探究有助于患有医学上无法解释病症的患者满意度的因素，我们提出以下问题：在全科医生（GP）与患有医学上无法解释的长期疲劳的女性患者的临床接触中，个体因素与关系因素在促进患者满意度方面的重要性如何？我们通过对2013年从一个肌痛性脑脊髓炎患者组织招募的431名女性净样本收集的调查数据进行统计分析来探讨这个问题。参与者被问及她们在挪威国家医疗系统中与全科医生接触的经历，分两个不同阶段：疾病发作后不久，以及过去12个月内的现任常规全科医生。问题围绕着有关共同理解和决策、被认真对待、得到应有的尊重以及被视为平等伙伴等主题展开。通过描述性统计和多变量逻辑回归分析，我们分别探究了她们的经历与个体因素和关系因素是如何相关的。在解释结果时使用了问卷中的自由文本评论。分析表明，全科医生与肌痛性脑脊髓炎患者医疗接触中的关系方面，尤其是连续性、医患观点的一致性以及由专科医生诊治，是患者满意度的重要催化剂。与未被转诊至专科医生的女性相比，被转诊至专科医生的女性对初次检查感到满意的概率高出六倍多。我们得出结论，持续护理以及处于基于共同基础——对患者病情的共同理解——的伙伴关系中的经历，能提高患有医学上无法解释的长期疲劳的女性患者的满意度。
