Clucas Claudine
Psychology Department, University of Chester, Parkgate Road, Chester, CH14BJ, UK.
Support Care Cancer. 2016 Apr;24(4):1719-28. doi: 10.1007/s00520-015-2973-5. Epub 2015 Oct 5.
Respect experiences are poorly understood despite respect being central to professionalism in health care and patient well-being, and needed for optimal patient care. This study explores which patient-perceived communication behaviours from hospital staff contribute most to cancer patients' respect experiences and account for variation in their experience by socio-demographic and clinical characteristics.
We present a secondary analysis of data from the 2012-2013 National Cancer Patient Experience Survey of 45,191 patients with a primary cancer diagnosis treated in English National Health Service trusts providing adult acute cancer services who provided data on experienced respect and dignity.
Both autonomy-supportive and caring/emotionally sensitive behaviours were associated with reported respect, although the latter showed stronger associations and accounted for most differences in reports of respect between patient groups. Differences in respect were found by gender, race/ethnicity, age, the presence of long-standing conditions, treatment response, time since first treated for cancer (p < .001), employment and type of cancer (p < .05).
The study questions the tendency to conceptualise respect primarily in terms of autonomy-supportive behaviours and shows the relative contribution of autonomy-supportive and caring/emotionally sensitive behaviours in explaining disparities in respect experiences. More attention should be paid to affective communication behaviours from hospital staff to reduce disparities in respect experiences.
尽管尊重是医疗保健专业精神和患者福祉的核心,也是优化患者护理所必需的,但人们对尊重体验的理解却很有限。本研究探讨医院工作人员哪些患者感知到的沟通行为对癌症患者的尊重体验贡献最大,并根据社会人口统计学和临床特征解释他们体验的差异。
我们对2012 - 2013年全国癌症患者体验调查的数据进行了二次分析,该调查涉及45191名在提供成人急性癌症服务的英国国家医疗服务信托机构接受原发性癌症诊断治疗的患者,他们提供了有关体验到的尊重和尊严的数据。
自主性支持行为和关怀/情感敏感行为都与报告的尊重相关,尽管后者显示出更强的关联,并解释了患者群体之间尊重报告的大部分差异。在尊重方面发现了性别、种族/民族、年龄、长期疾病的存在、治疗反应、首次治疗癌症后的时间(p < 0.001)、就业情况和癌症类型(p < 0.05)的差异。
该研究对主要从自主性支持行为角度概念化尊重的倾向提出了质疑,并显示了自主性支持行为和关怀/情感敏感行为在解释尊重体验差异方面的相对贡献。应更加关注医院工作人员的情感沟通行为,以减少尊重体验方面的差异。