Burro Roberto, Savardi Ugo, Annunziata Maria Antonietta, De Paoli Paolo, Bianchi Ivana
Department of Human Sciences, University of Verona, Verona, Italy.
National Cancer Institute IRCCS 'Centro di Riferimento Oncologico' (CRO), Aviano, Italy.
Patient Prefer Adherence. 2018 Mar 27;12:443-459. doi: 10.2147/PPA.S147091. eCollection 2018.
An extensive body of literature has demonstrated that many patients who have been asked to participate in clinical trials do not fully understand the informed consent forms. A parallel independent study has demonstrated that opposites have a special status in human cognitive organization: they are common to all-natural languages and are intuitively and naturally understood and learnt.
The study investigates whether, and how, the use of opposites impacts on doctor-patient communication: does using the terms "small-large" to describe a nodule (ie, bipolar communication) rather than speaking in terms of centimeters (ie, unipolar communication) affect a patient's understanding of the situation? And is it better to speak of "common-rare" side effects (ie, bipolar communication) instead of the number of people who have suffered from particular side effects (ie, unipolar communication)?
Two questionnaires were created and used, one presenting the information in terms of opposites (ie, bipolar communication) and another using unipolar communication.
The participants' perception of their situation (in terms of feeling healthy-ill, being at high-low risk, and their treatment requiring high-low commitment) varied in the two conditions. Moreover, self-reported levels of understanding and satisfaction with how the information was communicated were higher when opposites were used.
Since this is the first study that addresses the merits of using bipolar structures versus unipolar structures in doctor-patient communication, further work is needed to consolidate and expand on the results, involving not only simulated but also real diagnostic contexts.
The encouraging results imply that further testing of the use of opposites in informed consent forms and in doctor-patient communication is strongly advisable.
大量文献表明，许多被要求参与临床试验的患者并未完全理解知情同意书。一项平行独立研究表明，反义词在人类认知组织中具有特殊地位：它们存在于所有自然语言中，并且能被直观、自然地理解和学习。
本研究调查使用反义词是否以及如何影响医患沟通：用“小 - 大”来描述结节（即双极沟通）而非用厘米为单位（即单极沟通）是否会影响患者对病情的理解？用“常见 - 罕见”来描述副作用（即双极沟通）而非提及出现特定副作用的人数（即单极沟通）是否更好？
创建并使用了两份问卷，一份以反义词形式呈现信息（即双极沟通），另一份使用单极沟通。
在两种情况下，参与者对自身状况的认知（从感觉健康 - 患病、处于高 - 低风险以及治疗所需的高 - 低投入方面）有所不同。此外，使用反义词时，参与者自我报告的对信息传达方式的理解程度和满意度更高。
由于这是第一项探讨在医患沟通中使用双极结构与单极结构优缺点的研究，需要进一步开展工作以巩固和扩展研究结果，不仅要涉及模拟诊断情境，还要包括真实诊断情境。
令人鼓舞的结果表明，非常有必要进一步测试在知情同意书以及医患沟通中使用反义词的情况。
