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预测结肠镜检查后患者的安心程度:疾病信念的作用。

Predicting patient reassurance after colonoscopy: The role of illness beliefs.

机构信息

Department of Psychological Medicine, University of Auckland, New Zealand.

Mercy-Ascot Endoscopy, Auckland, New Zealand.

出版信息

J Psychosom Res. 2018 Nov;114:58-61. doi: 10.1016/j.jpsychores.2018.09.009. Epub 2018 Sep 20.

Abstract

OBJECTIVE

Failure to effectively reassure patients can lead to patients becoming distressed and seeking further medical care. Whilst existing studies have identified that patients' psychological and demographic characteristics can impact patient reassurance, little research has explored specific predictors of patient reassurance following a colonoscopy. This study investigates demographic and psychological predictors of patient reassurance after receiving normal test results following a colonoscopy.

METHODS

Eighty-five participants receiving colonoscopies due to gastrointestinal symptoms were recruited from two endoscopy clinics. Patients provided demographic information and completed questionnaires assessing illness perceptions, health-related anxiety, hypochondriasis, somatisation and state and trait anxiety prior to the colonoscopy, as well as reassurance the day after the colonoscopy. Seventy-three participants provided complete data and were included in the analyses. Pearson's correlations and hierarchical linear regression were conducted to examine the associations between the baseline variables and patient reassurance after the colonoscopy.

RESULTS

Health-related anxiety, hypochondriasis and four items from the Brief Illness Perceptions Questionnaire (consequence, identity, concern, and emotional response beliefs) were negatively correlated with reassurance (r's ranged from -0.28 to -0.54, P < .05). The hierarchical linear regression demonstrated that in the fully adjusted model, only consequence beliefs (i.e. negative beliefs regarding the impact of gastrointestinal symptoms) remained a robust predictor of reassurance (β = -0.56, P = .005).

CONCLUSION

This study extends existing research on patient reassurance and is the first study to demonstrate that illness beliefs predicted reassurance following a colonoscopy. These findings suggest that targeting consequence beliefs may be a useful intervention for improving patient reassurance following clinical investigations.

摘要

目的

未能有效地使患者安心可能导致患者感到不安并寻求进一步的医疗护理。虽然现有研究已经确定患者的心理和人口统计学特征会影响患者的安心程度,但很少有研究探讨结肠镜检查后患者安心的具体预测因素。本研究调查了接受结肠镜检查后获得正常检查结果的患者中,人口统计学和心理因素对患者安心程度的预测作用。

方法

从两个内窥镜诊所招募了 85 名因胃肠道症状而接受结肠镜检查的患者。患者在结肠镜检查前提供人口统计学信息,并完成了评估疾病认知、健康相关焦虑、疑病症、躯体化和状态及特质焦虑的问卷,以及在结肠镜检查后一天提供安心程度的评估。73 名患者提供了完整的数据并被纳入分析。进行 Pearson 相关分析和分层线性回归,以检验基线变量与结肠镜检查后患者安心程度之间的关联。

结果

健康相关焦虑、疑病症和 Brief Illness Perceptions Questionnaire(后果、身份、关注和情绪反应信念)的四个条目与安心程度呈负相关(r 值范围为-0.28 至-0.54,P<0.05)。分层线性回归表明,在完全调整的模型中,只有后果信念(即对胃肠道症状影响的负面信念)仍然是安心程度的一个强有力的预测因素(β=-0.56,P=0.005)。

结论

本研究扩展了关于患者安心程度的现有研究,也是首个证明疾病认知预测结肠镜检查后安心程度的研究。这些发现表明,针对后果信念可能是改善临床检查后患者安心程度的一种有效干预措施。

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