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医患关系与信息寻求行为:癌症沟通的四种取向

The Doctor-Patient Relationship and Information-Seeking Behavior: Four Orientations to Cancer Communication.

作者信息

Adamson Matthew, Choi Kelsey, Notaro Stephen, Cotoc Crina

机构信息

1 Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.

出版信息

J Palliat Care. 2018 Apr;33(2):79-87. doi: 10.1177/0825859718759881. Epub 2018 Mar 7.

Abstract

BACKGROUND

In cancer communication, patients and physicians often understand a patient's experience and situation differently. This can negatively impact health outcomes and the physician-patient relationship.

AIM

To explore how cancer patients' interpretations of the physician's role as information giver affect the communication relationship with the physician and their information-seeking behavior regarding different aspects of their cancer care.

DESIGN

Participants completed a semistructured qualitative interview addressing their treatment experience and communication with their physician. Interviews were coded and analyzed using inductive thematic analysis.

SETTING/PARTICIPANTS: Ten patients with cancer treated at a regional cancer center in central Illinois participated in the study. Cancer stages I to IV and 4 cancer types were represented.

RESULTS

Participants' orientations to the relationship with their physician (and their information-seeking behavior) were classified into 4 general categories: (1) "questioners" have a general mistrust toward their physicians and the information doctors are giving; (2) "the undecided" focuses on physician "fit," often requiring time to step away in order to make decisions and process information; (3) "cross-checkers" are concerned with content of their treatment protocol, often double-checking the treatment plan; and (4) "the experience-oriented" feel a gap between their experience and their physician's experience (and perspective), often seeking information from other survivors. All categories described a perceived lack of adequate exchange of information and the need to seek information outside of the physician-patient relationship to compensate.

CONCLUSION

Participants exhibited different information-seeking behaviors based on how they interpreted the role of their physician as information giver. This affected what kind of information they sought and how they understood the information received, which in turn affected understanding of their broader experience and care.

摘要

背景

在癌症沟通中,患者和医生对患者的经历和情况往往有不同的理解。这可能会对健康结果和医患关系产生负面影响。

目的

探讨癌症患者对医生作为信息提供者角色的理解如何影响与医生的沟通关系以及他们在癌症治疗不同方面的信息寻求行为。

设计

参与者完成了一项半结构化定性访谈,内容涉及他们的治疗经历以及与医生的沟通。访谈采用归纳主题分析法进行编码和分析。

地点/参与者:伊利诺伊州中部一家地区癌症中心的10名癌症患者参与了该研究。涵盖了I至IV期癌症以及4种癌症类型。

结果

参与者对与医生关系的定位(以及他们的信息寻求行为)分为4大类:(1)“质疑者”对医生以及医生提供的信息普遍不信任;(2)“犹豫不决者”关注医生是否合适,通常需要时间来抽身以便做出决定并处理信息;(3)“反复核对者”关注治疗方案的内容,经常反复核对治疗计划;(4)“注重经验者”感觉自己的经历与医生的经历(和观点)之间存在差距,经常从其他幸存者那里寻求信息。所有类别都描述了感觉缺乏充分的信息交流,以及需要在医患关系之外寻求信息以作补充。

结论

参与者根据他们对医生作为信息提供者角色的理解表现出不同的信息寻求行为。这影响了他们寻求何种信息以及如何理解所获得的信息,进而影响了对其更广泛经历和治疗的理解。

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