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医患关系似乎会影响癌症患者的镇痛药使用依从性:一项针对台湾人群的横断面研究。

Patient-clinician relationship seems to affect adherence to analgesic use in cancer patients: a cross sectional study in a Taiwanese population.

作者信息

Chou Pi-Ling, Rau Kun-Ming, Yu Ta-Wei, Huang Tai-Lin, Sun Jia-Ling, Wang Shu-Yi, Lin Chia-Chin

机构信息

School of Nursing, College of Nursing, Kaohsiung Medical University, Nursing supervisor, Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

出版信息

Int J Qual Health Care. 2017 Nov 1;29(7):935-940. doi: 10.1093/intqhc/mzx134.

Abstract

OBJECTIVES

Patient satisfaction can provide a measure of service quality and serve as a predictor of health-related behaviors. Little is known about how patients' satisfaction with clinician-patient interactions affects their adherence to taking analgesics. The purposes of this study were to (1) investigate the predictors of patients' satisfaction with clinicians, and (2) examine whether patients' satisfaction with their clinicians can improve adherence to analgesic use.

DESIGN

A cross-sectional and descriptive design was used.

SETTING

Outpatient oncology clinic at a medical center in Taiwan.

PARTICIPANTS

A convenience sample (N = 309) was recruited.

MAIN OUTCOME MEASURES

The Medical Interview Satisfaction Scale 21 - Chinese Version, Short Version of the Barriers Questionnaire - Taiwan Form, Taiwanese version of the Morisky Medication Adherence Measure, and Interpersonal Physician Trust Scale - Chinese version, and Brief Pain Inventory Chinese Version.

RESULTS

Variables that could significantly predict patients' satisfaction were patient age and trust in clinicians, which together accounted for 33% of the total variance. Patients' satisfaction with their clinicians significantly predicted patients' adherence to medication use (OR = 3.10, P < 0.05). There was an interactive effect (OR = 0.12, P < 0.05) between patients' satisfaction and barriers to analgesic use. Correlation coefficients between barriers to analgesic use and patients' adherence are -0.52 (P < 0.001) and -0.13 (P = 0.20) in the higher satisfaction and lower satisfaction patients, respectively.

CONCLUSIONS

Patients' satisfaction with their clinicians can have a positive effect on changing analgesics adherence behaviors when patients hold incorrect beliefs about analgesics. Patients' satisfaction has an important role in enhancement of analgesics adherence behaviors.

摘要

目的

患者满意度可作为服务质量的衡量标准,并可预测与健康相关的行为。关于患者对医患互动的满意度如何影响其镇痛药服用依从性,目前所知甚少。本研究的目的是:(1)调查患者对临床医生满意度的预测因素;(2)检验患者对临床医生的满意度是否能提高镇痛药使用的依从性。

设计

采用横断面描述性设计。

地点

台湾某医疗中心的门诊肿瘤科。

参与者

招募了一个便利样本(N = 309)。

主要观察指标

医学访谈满意度量表21中文版、障碍问卷简版 - 台湾版、台湾版莫利斯基药物依从性量表、人际医生信任量表中文版和简明疼痛问卷中文版。

结果

可显著预测患者满意度的变量为患者年龄和对临床医生的信任,二者共同解释了总方差的33%。患者对临床医生的满意度显著预测了患者的药物使用依从性(OR = 3.10,P < 0.05)。患者满意度与镇痛药使用障碍之间存在交互作用(OR = 0.12,P < 0.05)。在满意度较高和较低的患者中,镇痛药使用障碍与患者依从性的相关系数分别为 -0.52(P < 0.001)和 -0.13(P = 0.20)。

结论

当患者对镇痛药持有错误观念时,患者对临床医生的满意度可对改变镇痛药依从行为产生积极影响。患者满意度在增强镇痛药依从行为方面具有重要作用。

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