Jeong Shin Ok, Uh Soo-Taek, Park Suyeon, Kim Hyun-Sook
Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
Biostatistics, Soonchunhyang University Hospital, Seoul, Korea.
Int J Rheum Dis. 2018 Aug;21(8):1600-1608. doi: 10.1111/1756-185X.13331.
Multidisciplinary discussions (MDDs) have emphasized improve medical services and outcomes. We used a multidisciplinary approach to explore whether patient emotional satisfaction and confidence affected treatment outcomes in rheumatic disease (RD)-related interstitial lung disease (ILD).
From December 2015 to April 2017, we evaluated 23 patients with RD and ILD and 21 with idiopathic pulmonary fibrosis (IPF). Patients with RD and ILD were managed with MDDs. Patients with IPF received standardized medical care by the same pulmonologist. All patients completed brief multiple-choice questionnaires exploring their perceptions of their illnesses and their attitudes toward medical treatment, and completed the Patient Health Questionnaire-2.
The MDD patients could more easily identify disease symptoms regardless of age stratification (under 65 age: P = 0.020, 65 years or older: P = 0.003). Among the 65 years or older group, it shows higher levels of illness perception in terms of disease timeline in the MDD group (P = 0.035). Also, the MDD group reported higher levels of satisfaction in terms of the explanations they received and their involvement in discussion, and greater satisfaction with medical staff. However, the groups did not differ significantly between treatment outcomes such as changes in forced vital capacity, the diffusion capacity of carbon monoxide, or changes in high-resolution computed tomography.
MDDs afforded satisfactory management compared with standardized medical care. The MDD group felt better attention fromand satisfaction with medical staff, and had greater identification in their treatment. Further research engaging in MDDs with a comparable control group is required.
多学科讨论(MDDs)强调改善医疗服务和治疗效果。我们采用多学科方法探讨患者的情感满意度和信心是否会影响风湿性疾病(RD)相关间质性肺病(ILD)的治疗效果。
2015年12月至2017年4月,我们评估了23例患有RD和ILD的患者以及21例特发性肺纤维化(IPF)患者。患有RD和ILD的患者接受了多学科讨论管理。IPF患者由同一位肺科医生提供标准化医疗护理。所有患者均完成了简短的多项选择题问卷,以探讨他们对自身疾病的认知以及对医疗治疗的态度,并完成了患者健康问卷-2。
无论年龄分层如何(65岁以下:P = 0.020,65岁及以上:P = 0.003),多学科讨论管理的患者能够更轻松地识别疾病症状。在65岁及以上的年龄组中,多学科讨论管理组在疾病时间线方面的疾病认知水平更高(P = 0.035)。此外,多学科讨论管理组在他们所获得的解释以及参与讨论方面报告了更高的满意度,并且对医务人员的满意度更高。然而,在诸如用力肺活量变化、一氧化碳弥散能力或高分辨率计算机断层扫描变化等治疗效果方面,两组之间没有显著差异。
与标准化医疗护理相比,多学科讨论管理提供了令人满意的管理。多学科讨论管理组感觉受到医务人员更多关注且对其满意度更高,并且在治疗方面有更强的认同感。需要进一步开展有可比对照组的多学科讨论管理研究。