Náfrádi Lilla, Kostova Zlatina, Nakamoto Kent, Schulz Peter J
1 Institute of Communication and Health, Universita della Svizzera Italiana, Università della Svizzera Italiana, Lugano, Switzerland.
2 Department of Psychiatry, University of Massachusetts Medical School, Worcester, USA.
Chronic Illn. 2018 Dec;14(4):256-270. doi: 10.1177/1742395317739961. Epub 2017 Nov 2.
To study patients' perspectives about the role of the doctor-patient relationship in promoting the resilience process.
We conducted in-depth interviews with 20 chronic pain patients. Using open-ended questions, the interviews explored aspects of the doctor-patient relationship that impacted the patients' perceptions of their resilience. Thematic analysis built on an inductive, adaptive approach to data coding was employed to organize a representation of key factors affecting resilience.
The themes emerging from the interviews inform us about how the different aspects of the doctor-patient relationship can promote patient resilience in chronic pain. Three main themes emerged: the doctor providing psychological support, promoting patients' health literacy related to chronic pain and its treatment, and empowering the patients to cooperate in finding the right treatment. This fosters patients' direct outcomes (feeling validated, health literate, and empowered), which, in turn, lead to adaptive coping responses and day-to-day disease management. These direct outcomes are crucial for patients to maintain socially and personally meaningful activities and their functional (physical) capacity.
A doctor-patient relationship following the precepts of the patient-centered care is a significant resource that can lead to increased patient resilience. Thus, future interventions promoting patient resilience might consider addressing the doctor-patient relationship.
研究患者对医患关系在促进恢复力过程中所起作用的看法。
我们对20名慢性疼痛患者进行了深入访谈。通过开放式问题，访谈探讨了医患关系中影响患者恢复力认知的各个方面。采用基于归纳、适应性数据编码方法的主题分析来组织影响恢复力的关键因素的呈现。
访谈中出现的主题让我们了解到医患关系的不同方面如何促进慢性疼痛患者的恢复力。出现了三个主要主题：医生提供心理支持、提高患者与慢性疼痛及其治疗相关的健康素养，以及使患者有能力配合寻找合适的治疗方法。这促进了患者的直接结果（感到被认可、有健康素养和有能力），进而导致适应性应对反应和日常疾病管理。这些直接结果对于患者维持社会和个人有意义的活动及其功能（身体）能力至关重要。
遵循以患者为中心的护理原则的医患关系是一种重要资源，可提高患者的恢复力。因此，未来促进患者恢复力的干预措施可能会考虑关注医患关系。
