Ernstmann Nicole, Wirtz Markus, Nitzsche Anika, Gross Sophie E, Ansmann Lena, Gloede Tristan D, Jung Julia, Pfaff Holger, Baumann Walter, Schmitz Stephan, Neumann Melanie
Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
Department for Research Methodology, University of Education, Kunzenweg 21, 79117, Freiburg, Germany.
J Cancer Educ. 2017 Sep;32(3):571-579. doi: 10.1007/s13187-017-1166-y.
In cancer care, where patients and their families experience significant emotional distress and patients have to deal with complex medical information, patient centeredness is an important aspect of quality of care. The aim of this study is to examine the impact of patients' trust in their oncologists and patients' enablement on changes in health-related quality of life of colon cancer patients during follow-up care. We conducted a prospective study in a representative sample of private practices of German oncologists (N = 44). Patients (N = 131) filled out a standardized questionnaire prior to their first consultation (T0), directly after the first consultation (T1) and after two months (T2). Data were analyzed by structural equation modeling. Significant associations were found between trust in physician and changes in physical functioning between T1 and T2, and between trust in physician and patient enablement. Patient enablement is significantly associated with changes in physical functioning between T1 and T2. The results underline the importance of building a close and trustful patient-physician relationship in the oncology encounter. A central mechanism of the association between the quality of the relationship and health outcomes seems to be patient enablement. To enable patients to cope with their situation by making them understand their diagnosis, treatments, and side effects can impact health-related quality of life in physical domains.
在癌症护理中，患者及其家属会经历巨大的情绪困扰，患者必须处理复杂的医学信息，以患者为中心是护理质量的一个重要方面。本研究的目的是探讨患者对肿瘤学家的信任以及患者的赋能对结肠癌患者随访期间健康相关生活质量变化的影响。我们在德国肿瘤学家私人诊所的代表性样本（N = 44）中进行了一项前瞻性研究。患者（N = 131）在首次咨询前（T0）、首次咨询后立即（T1）和两个月后（T2）填写了一份标准化问卷。通过结构方程模型对数据进行分析。结果发现，对医生的信任与T1和T2之间身体功能的变化之间存在显著关联，对医生的信任与患者赋能之间也存在显著关联。患者赋能与T1和T2之间身体功能的变化显著相关。这些结果强调了在肿瘤诊疗过程中建立密切且相互信任的医患关系的重要性。医患关系质量与健康结果之间关联的一个核心机制似乎是患者赋能。通过让患者了解自己的诊断、治疗和副作用，使他们能够应对自身状况，这会对身体方面的健康相关生活质量产生影响。
