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患者对医疗服务提供者沟通的认知与身体疼痛体验有关吗?

Do patient perceptions of provider communication relate to experiences of physical pain?

作者信息

Ruben Mollie A, Meterko Mark, Bokhour Barbara G

机构信息

School of Arts & Sciences, Massachusetts College of Pharmacy and Health Sciences (MCPHS) University, United States; Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, United States.

Department of Health Law, Policy and Management, Boston University School of Public Health, United States; Performance Measurement, VHA Office of Reporting, Analytics, Performance, Improvement and Deployment (RAPID - 10EA), United States.

出版信息

Patient Educ Couns. 2018 Feb;101(2):209-213. doi: 10.1016/j.pec.2017.08.002. Epub 2017 Aug 4.

Abstract

OBJECTIVES

Patient-provider communication is an important component of the medical interaction yet little research has examined the relationships between perceptions of communication and health outcomes or the mechanisms by which communication may ameliorate the pain experience. This is the first study to examine the relationships between patients' perceptions of provider communication, pain intensity and self-efficacy for managing chronic disease.

METHODS

The total sample contained 1027 (85.8% male) Veteran patients. Patients responded to surveys about their experiences and outcomes of care, including measures of patient-provider communication, self-efficacy and pain outcomes including pain intensity and pain interference.

RESULTS

Results showed more positive perceptions of provider communication were related to lower levels of pain intensity and pain interference and that this relationship was significantly mediated by higher levels of self-efficacy for managing chronic disease.

CONCLUSION

More positive provider communication was related to higher levels of self-efficacy, which in turn was related to lower levels of pain intensity and pain interference. Findings suggest that providers may be able to elicit higher levels of self-efficacy in their patients by providing patient-centered communication, which in turn will reduce pain intensity and interference in their patient's lives.

摘要

目的

医患沟通是医疗互动的重要组成部分,但很少有研究探讨沟通认知与健康结果之间的关系,或沟通可能改善疼痛体验的机制。这是第一项研究患者对医护人员沟通的认知、疼痛强度与慢性病管理自我效能之间的关系。

方法

总样本包括1027名退伍军人患者(85.8%为男性)。患者对有关其护理经历和结果的调查做出回应,包括医患沟通、自我效能以及疼痛结果(包括疼痛强度和疼痛干扰)的测量。

结果

结果显示,对医护人员沟通的更积极认知与较低水平的疼痛强度和疼痛干扰相关,并且这种关系通过更高水平的慢性病管理自我效能得到显著中介。

结论

更积极的医护人员沟通与更高水平的自我效能相关,而自我效能又与更低水平的疼痛强度和疼痛干扰相关。研究结果表明,医护人员通过提供以患者为中心的沟通,可能能够提高患者的自我效能水平,进而减轻患者的疼痛强度并减少疼痛对其生活的干扰。

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