Cardiology Unit, S. Maria Annunziata Hospital, Florence, Italy.
Cardiology Unit, S. Maria Nuova Hospital, Florence, Italy.
Biomed Res Int. 2017;2017:2792131. doi: 10.1155/2017/2792131. Epub 2017 Nov 21.
Strategies to improve doctor-patient communication may have a beneficial impact on patient's illness experience and mood, with potential favorable clinical effects. We prospectively tested the psychometric and clinical validity of the Decalogue, a tool utilizing 10 communication recommendations for patients and physicians. The Decalogue was administered to 100 consecutive patients referred for a cardiologic consultation, whereas 49 patients served as controls. The POMS-2 questionnaire was used to measure the total mood disturbance at the end of the consultation. Structural equation modeling showed high internal consistency (Cronbach alpha 0.93), good test-retest reproducibility, and high validity of the psychometric construct (all > 0.80), suggesting a positive effect on patients' illness experience. The total mood disturbance was lower in the patients exposed to the Decalogue as compared to the controls (1.4 ± 12.1 versus 14.8 ± 27.6, = 0.0010). In an additional questionnaire, patients in the Decalogue group showed a trend towards a better understanding of their state of health ( = 0.07). In a cardiologic ambulatory setting, the Decalogue shows good validity and reliability as a tool to improve patients' illness experience and could have a favorable impact on mood states. These effects might potentially improve patient engagement in care and adherence to therapy, as well as clinical outcome.
改善医患沟通的策略可能对患者的疾病体验和情绪产生有益影响,并可能产生有利的临床效果。我们前瞻性地测试了十诫的心理测量学和临床有效性,这是一种利用 10 条针对患者和医生的沟通建议的工具。十诫被应用于 100 名连续就诊的心脏病患者,而 49 名患者作为对照组。在咨询结束时,使用 POMS-2 问卷来衡量总体情绪困扰。结构方程模型显示出较高的内部一致性(Cronbach alpha 0.93)、良好的重测信度和心理测量结构的高有效性(均> 0.80),这表明对患者的疾病体验有积极影响。与对照组相比,接受十诫的患者的总体情绪困扰较低(1.4 ± 12.1 与 14.8 ± 27.6, = 0.0010)。在另外的问卷中,十诫组的患者表现出对自身健康状况更好理解的趋势( = 0.07)。在心脏病门诊环境中,十诫作为改善患者疾病体验的工具具有良好的有效性和可靠性,可能对情绪状态产生有利影响。这些影响可能潜在地改善患者对治疗的参与度和依从性,以及临床结果。