Guo Jong-Long, Tu Ku Hsin-Yi, Yang Fu-Chi, Hsu Hsiao-Pei, Lin Yun-Hsuan, Huang Chiu-Mieh
Department of Health Promotion and Health Education, University of National Taiwan Normal University, Taipei, Taiwan.
Department of Nursing, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, Taiwan.
Scand J Caring Sci. 2017 Dec;31(4):748-758. doi: 10.1111/scs.12394. Epub 2016 Nov 16.
The recurrence of menstrual symptoms markedly interferes with the daily life, social functioning, work disability and quality of life of women. Patient perception of healthcare services is underexplored but crucial for understanding how to efficiently develop healthcare practices.
To identify and describe the different patterns of treatment expectation and physician-patient relationships perceived by women receiving traditional Chinese medicine treatment for menstrual symptoms.
A two-stage data collection design was used. In the first stage, in-depth interviews with 40 participants were conducted; the interview data were used for content analysis. Q statements were developed on the basis of the content analysis results. In the second stage, a series of Q sorts was performed by 60 other participants to subjectively rank the Q statements.
The results of factor analysis revealed that four factors retained in the final model accounted for 56% of total variance. Women associated with Factor 1 had experienced few negative physician-patient interactions; these women were relatively young (31.6 years) and had mild perimenstrual mood discomfort (6.4). Women who loaded on Factor 2 preferred physician guidance and encountered few barriers to adherence; these participants were older (38.6 years) and had the most severe perimenstrual mood discomfort (9.5) among the four groups. The women in agreement with Factor 3 tended to patiently wait for treatment effects; these participants had the highest scores for both cyclic pelvic pain (4.9) and perimenstrual physical discomfort (8.8). The women associated with Factor 4 demanded effective treatment and had the lowest scores for both cyclic pelvic pain (3.8) and perimenstrual physical discomfort (6.8).
The exploration of clustering patients according to their perspectives could influence healthcare providers to acknowledge patient expectations and enable effective communication between physicians and patients.
月经症状的复发严重干扰女性的日常生活、社交功能、工作能力及生活质量。患者对医疗服务的认知尚未得到充分探索，但对于理解如何高效开展医疗实践至关重要。
识别并描述接受中药治疗月经症状的女性对治疗期望和医患关系的不同模式。
采用两阶段数据收集设计。第一阶段，对40名参与者进行深入访谈；访谈数据用于内容分析。根据内容分析结果编制Q语句。第二阶段，另外60名参与者进行一系列Q分类，对Q语句进行主观排序。
因子分析结果显示，最终模型中保留的四个因子占总方差的56%。与因子1相关的女性经历的负面医患互动较少；这些女性相对年轻（31.6岁），经前情绪不适较轻（6.4）。加载在因子2上的女性更喜欢医生指导，依从性障碍较少；这些参与者年龄较大（38.6岁），在四组中经前情绪不适最严重（9.5）。认同因子3的女性倾向于耐心等待治疗效果；这些参与者在周期性盆腔疼痛（4.9）和经前身体不适（8.8）方面得分最高。与因子4相关的女性要求有效治疗，在周期性盆腔疼痛（3.8）和经前身体不适（6.8）方面得分最低。
根据患者观点对患者进行聚类分析，可能会促使医疗服务提供者了解患者期望，并促进医患之间的有效沟通。
