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在遭受慢性疼痛时怀有准确的治疗期望:对治疗期望及其与医患沟通关系的探索

Entertaining accurate treatment expectations while suffering from chronic pain: an exploration of treatment expectations and the relationship with patient- provider communication.

作者信息

Wiering Bianca, de Boer Dolf, Krol Maarten, Wieberneit-Tolman Hilda, Delnoij Diana

机构信息

Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, PO Box 90153, 5000, LE, Tilburg, The Netherlands.

NIVEL (Netherlands institute for health services research), Utrecht, the Netherlands.

出版信息

BMC Health Serv Res. 2018 Sep 11;18(1):706. doi: 10.1186/s12913-018-3497-8.

Abstract

BACKGROUND

Accurate patient expectations are important to optimise treatment success, especially for complex conditions such as chronic pain. Communication may be the key to managing patient expectations. This study aimed to explore whether health care provider communication influences patient expectations and which communication aspects are most important.

METHODS

We conducted secondary analyses on data that had been collected between September and November 2012. 2603 patients suffering from chronic pain were invited to complete a survey.

RESULTS

Although 69.9% of patients achieved or surpassed their treatment goal, 30.2% of patients were unsatisfied. Even though overall health care provider communication and shared decision making were unrelated to patient expectations, several affective communication aspects were related. These aspects were attentive listening, taking enough time, building patient's trust in the physician's competence and giving patients the feeling that the physician is doing all he or she can (p's < 0.05).

CONCLUSIONS

Even though treatment goals are not always explicitly discussed, patients still form expectations regarding treatment outcomes. Affective communication may be more important for managing patient expectations than sharing information. Building a good therapeutic relationship by showing affective communication may be important to increase the accuracy of patient expectations.

摘要

背景

准确的患者期望对于优化治疗效果至关重要,尤其是对于慢性疼痛等复杂病症。沟通可能是管理患者期望的关键。本研究旨在探讨医疗服务提供者的沟通是否会影响患者期望,以及哪些沟通方面最为重要。

方法

我们对2012年9月至11月期间收集的数据进行了二次分析。邀请了2603名慢性疼痛患者完成一项调查。

结果

尽管69.9%的患者达到或超过了他们的治疗目标,但仍有30.2%的患者不满意。尽管总体上医疗服务提供者的沟通和共同决策与患者期望无关,但几个情感沟通方面是相关的。这些方面包括专注倾听、给予足够时间、建立患者对医生能力的信任以及让患者感觉到医生正在尽他或她所能(p值<0.05)。

结论

尽管治疗目标并非总是明确讨论,但患者仍然会对治疗结果形成期望。情感沟通对于管理患者期望可能比分享信息更为重要。通过展示情感沟通建立良好的治疗关系可能对于提高患者期望的准确性很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/233a/6131883/b8682957eaa5/12913_2018_3497_Fig1_HTML.jpg

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