Wood Troy J, Koester Kimberly A, Christopoulos Katerina A, Sauceda John A, Neilands Torsten B, Johnson Mallory O
Department of Medicine, University of California, San Francisco, CA, USA.
AIDS Policy Research Center, Department of Medicine, University of California, San Francisco, CA, USA.
Patient Prefer Adherence. 2018 May 24;12:919-927. doi: 10.2147/PPA.S157003. eCollection 2018.
The patient-provider relationship is a central factor that can promote or hinder long-term engagement in care among people living with chronic illnesses. In this paper, we explore characteristics of the patient-provider relationship that facilitated or hindered engagement in care among patients receiving care at HIV specialty clinics.
We conducted 6 focus group discussions with a total of 43 well-retained and less well-retained HIV+ patients in San Francisco, Seattle, and Birmingham, to elicit a wide range of perspectives on engagement in HIV care. Borrowing from the field of psychotherapy, we examined patient-provider relationship characteristics through the lens of the therapeutic alliance, and with regard to their therapeutic efficacy and impact on patient engagement.
The majority of participants emphasized how a strong patient-provider relationship defined by trust, intimacy, and collaboration promoted engagement, while a weak patient-provider relationship impeded engagement.
We discuss practical strategies and therapeutic techniques that may be helpful to providers in building strong patient-provider relationship and contend that a strong patient-provider relationship is crucial for patients to feel cared for during clinical encounters, which can promote long-term and sustained engagement in HIV care.
医患关系是一个核心因素，它既能促进也能阻碍慢性病患者长期接受治疗。在本文中，我们探讨了医患关系的特征，这些特征在接受艾滋病专科诊所治疗的患者中，对治疗参与起到了促进或阻碍作用。
我们在旧金山、西雅图和伯明翰对总共43名依从性好和依从性差的HIV阳性患者进行了6次焦点小组讨论，以获取关于艾滋病治疗参与的广泛观点。借鉴心理治疗领域的方法，我们从治疗联盟的角度审视医患关系特征，以及它们的治疗效果和对患者治疗参与的影响。
大多数参与者强调，由信任、亲密和协作所定义的强大医患关系如何促进了治疗参与，而薄弱的医患关系则阻碍了治疗参与。
我们讨论了一些实用策略和治疗技巧，这些可能有助于医护人员建立强大的医患关系，并认为强大的医患关系对于患者在临床诊疗过程中感受到关怀至关重要，这可以促进其长期持续参与艾滋病治疗。
