糖尿病患者的健康相关生活质量与对基层医疗医生的信任之间的关系
The Relationship Between Health-Related Quality of Life and Trust in Primary Care Physicians Among Patients with Diabetes.
作者信息
AlRuthia Yazed, Sales Ibrahim, Almalag Haya, Alwhaibi Monira, Almosabhi Latifa, Albassam Ahmed A, Alharbi Fawaz Abdullah, Bashatah Adel, Asiri Yousif
机构信息
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
出版信息
Clin Epidemiol. 2020 Feb 5;12:143-151. doi: 10.2147/CLEP.S236952. eCollection 2020.
BACKGROUND
Trust is pivotal for a productive relationship between patients and healthcare providers and is positively correlated with multiple clinical and humanistic outcomes. However, the impact of trust in healthcare providers on different domains of health-related quality of life (HRQoL) among diabetic patients has not been studied in detail.
PURPOSE
The aim of this study was to examine the association between the physical, mental or psychological, social, and environmental domains of HRQoL with the patients' trust in their primary care physicians while controlling for several sociodemographic and clinical factors. The study was conducted among a sample of diabetic patients.
PATIENTS AND METHODS
This study had a prospective questionnaire-based, multi-center, cross-sectional design. The patients were recruited from three public hospitals in Saudi Arabia. Patients' experiences and trust in their primary care physicians were assessed using the Health Care Relationship Trust (HCR-Trust) scale. HRQoL was assessed using the Arabic version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Multiple linear regression was conducted to assess the relationship between HCR-Trust and the WHOQOL-BREF physical, psychological, social, and environmental domains controlling for age, Charlson Comorbidity Index (CCI) score, health literacy, sex, education, annual income, nationality, and illness duration.
RESULTS
Three hundred and sixty-four patients participated in the study. The scores in all four domains of WHOQOL-BREF were positively associated with HCR-Trust scores of the diabetic patients. Additionally, the scores in the physical (β = -10.26; 95% CI: -13.77 to -6.74; < 0.0001) and psychological (β = -3.91; 95% CI: -7.44 to -0.38; < 0.0001) domains were negatively associated with female gender. Furthermore, the physical domain score was negatively associated with the duration of illness (β = -0.26; 95% CI: -0.506 to -0.02; P = 0.032). The environmental domain score was positively associated with annual income (β = 2.31; 95% CI: 1.05 to 3.56; = 0.030). Other patient characteristics, such as age and education, were not associated with the scores of any of the WHOQOL-BREF domains.
CONCLUSION
Patient trust in healthcare providers is positively associated with different domains of HRQoL. Therefore, building and maintaining trust with patients is important to achieve favorable treatment outcomes.
背景
信任对于患者与医疗服务提供者之间富有成效的关系至关重要，并且与多种临床和人文结果呈正相关。然而，医疗服务提供者的信任对糖尿病患者健康相关生活质量（HRQoL）不同领域的影响尚未得到详细研究。
目的
本研究的目的是在控制若干社会人口学和临床因素的同时，检验HRQoL的身体、心理、社会和环境领域与患者对其初级保健医生的信任之间的关联。该研究在糖尿病患者样本中进行。
患者与方法
本研究采用基于问卷的前瞻性、多中心横断面设计。患者从沙特阿拉伯的三家公立医院招募。使用医疗保健关系信任（HCR-Trust）量表评估患者对其初级保健医生的体验和信任。使用世界卫生组织生活质量简表（WHOQOL-BREF）的阿拉伯语版本评估HRQoL。进行多元线性回归以评估HCR-Trust与WHOQOL-BREF身体、心理、社会和环境领域之间的关系，同时控制年龄、查尔森合并症指数（CCI）评分、健康素养、性别、教育程度、年收入、国籍和病程。
结果
364名患者参与了研究。WHOQOL-BREF所有四个领域的得分均与糖尿病患者的HCR-Trust得分呈正相关。此外，身体领域（β = -10.26；95%CI：-13.77至-6.74；<0.0001）和心理领域（β = -3.91；95%CI：-7.44至-0.38；<0.0001）的得分与女性性别呈负相关。此外，身体领域得分与病程呈负相关（β = -0.26；95%CI：-0.506至-0.02；P = 0.032）。环境领域得分与年收入呈正相关（β = 2.31；95%CI：1.05至3.56；= 0.030）。其他患者特征，如年龄和教育程度，与WHOQOL-BREF任何领域的得分均无关联。
结论
患者对医疗服务提供者的信任与HRQoL的不同领域呈正相关。因此，与患者建立和维持信任对于实现良好的治疗效果很重要。
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