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纤维肌痛症患者的疾病认知和来自医务人员的负面反应:与患者满意度和就诊次数的关联。

Illness perceptions and negative responses from medical professionals in patients with fibromyalgia: Association with patient satisfaction and number of hospital visits.

机构信息

Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan.

Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan.

出版信息

Patient Educ Couns. 2018 Mar;101(3):532-540. doi: 10.1016/j.pec.2017.08.014. Epub 2017 Aug 30.

Abstract

OBJECTIVE

To examine whether illness perceptions among patients with fibromyalgia and negative responses from medical professionals correlate with their satisfaction with their physicians or with their number of hospital visits.

METHODS

Questionnaires were sent by post to members of the Japan Fibromyalgia Support Association. Measures collected included, as independent variables, the Brief Illness Perception Questionnaire and the Illness Invalidation Inventory; and as outcomes, the Patient Satisfaction Consultation Questionnaire and the number of hospital visits.

RESULTS

We analyzed data from 304 patients. Multiple logistic regressions showed that perception of poor treatment control and the experience of being discounted and misunderstood by medical professionals were strongly correlated with dissatisfaction with attending physicians. Patients who perceived poor treatment control visited the hospital fewer times, while patients who reported being discounted by medical professionals visited more times. Patients' negative emotions correlated neither with patient satisfaction nor with the number of hospital visits.

CONCLUSION

Treatment effectiveness and the respect accorded to patients were the key factors significantly correlated both with patient satisfaction and the number of hospital visits.

PRACTICE IMPLICATIONS

Physicians should not emphasize only patients' negative psychological status but also should convey a respectful attitude and help patients understand their current treatment is useful.

摘要

目的

考察纤维肌痛患者的疾病认知和来自医疗专业人员的负面反应是否与其对医生的满意度或就诊次数有关。

方法

通过邮寄方式向日本纤维肌痛支持协会的成员发送问卷。收集的测量指标包括简短疾病感知问卷和疾病否定性评估量表;作为结果,采用患者满意度咨询问卷和就诊次数。

结果

我们分析了 304 名患者的数据。多变量逻辑回归显示,治疗控制感差和被医疗专业人员轻视和误解的经历与对主治医生的不满密切相关。感知治疗控制差的患者就诊次数较少,而报告被医疗专业人员轻视的患者就诊次数较多。患者的负面情绪与患者满意度和就诊次数均无相关性。

结论

治疗效果和对患者的尊重是与患者满意度和就诊次数显著相关的关键因素。

实践意义

医生不应只强调患者的负面心理状态,还应传达出尊重的态度,并帮助患者理解他们目前的治疗是有效的。

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