一个令人眩晕的主诉：调查患者和提供者对头晕的意向性含义。
A Dizzying Complaint: Investigating the Intended Meaning of Dizziness Among Patients and Providers.
机构信息
Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.
Department of Otolaryngology - Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.
出版信息
Laryngoscope. 2021 May;131(5):E1443-E1449. doi: 10.1002/lary.29271. Epub 2020 Nov 13.
OBJECTIVE/HYPOTHESIS: To assess for semantic differences regarding the definition of dizziness among otolaryngology patients, otolaryngologists, and non-otolaryngologist providers.
STUDY DESIGN
Cross-sectional survey.
METHODS
Between March and May 2020, a survey consisting of 20 common descriptors for dizziness within five domains (lightheadedness, motion sensitivity, imbalance, vision complaints, and pain) was completed by patients at two outpatient otolaryngology clinics. Surveys were subsequently obtained from otolaryngology and non-otolaryngology providers attending a multidisciplinary dizziness lecture. The primary outcome measure was to assess for differences in definition of dizziness between patients and providers. Secondary outcome measures included assessing differences between otolaryngologists and non-otolaryngologists.
RESULTS
About 221 patients and 100 providers participated. Patients selected a median of 7 terms compared to 8 for providers (P = .375), although providers had a larger overall distribution of number of terms selected (P = .038). Patients were more likely than providers to define dizziness according to the following domains: lightheadedness (difference 15.0%; 95% confidence interval [CI] 5.5%-25.3%), vision complaints (difference 21.6%, 95% CI 12.0%-29.6%), and pain (difference 11.5%, 95% CI 4.7%-17.1%). Providers were more likely to define dizziness according to the motion sensitivity domain (difference 13.8%, 95% CI 6.8%-19.6%). Otolaryngology and non-otolaryngology providers defined dizziness similarly across symptom domains.
CONCLUSION
Although patients and providers both view dizziness as imbalance, patients more commonly describe dizziness in the context of lightheadedness, vision complaints, and pain, whereas providers more frequently define dizziness according to motion sensitivity. These semantic differences create an additional barrier to effective patient-provider communication.
LEVEL OF EVIDENCE
- Laryngoscope, 131:E1443-E1449, 2021.
目的/假设：评估耳鼻喉科患者、耳鼻喉科医生和非耳鼻喉科医生对头晕定义的语义差异。
研究设计
横断面调查。
方法
在 2020 年 3 月至 5 月期间，两名门诊耳鼻喉科诊所的患者完成了一项包含五个领域（头晕、运动敏感、失衡、视力投诉和疼痛）的 20 个常见头晕描述符的调查。随后，耳鼻喉科和非耳鼻喉科医生在参加多学科头晕讲座时获得了调查。主要结局指标是评估患者和提供者对头晕定义的差异。次要结局指标包括评估耳鼻喉科医生和非耳鼻喉科医生之间的差异。
结果
约有 221 名患者和 100 名提供者参与。与提供者相比，患者选择中位数为 7 个术语，而选择 8 个术语（P =.375），尽管提供者选择的术语数量分布范围更大（P =.038）。患者比提供者更有可能根据以下领域定义头晕：头晕（差异 15.0%，95%置信区间 [CI] 5.5%-25.3%）、视力投诉（差异 21.6%，95% CI 12.0%-29.6%）和疼痛（差异 11.5%，95% CI 4.7%-17.1%）。提供者更有可能根据运动敏感领域定义头晕（差异 13.8%，95% CI 6.8%-19.6%）。耳鼻喉科和非耳鼻喉科提供者在症状领域对头晕的定义相似。
结论
尽管患者和提供者都将头晕视为失衡，但患者更常描述头晕的情况是头晕、视力投诉和疼痛，而提供者更常根据运动敏感来定义头晕。这些语义差异为有效的医患沟通增加了额外的障碍。
证据水平
- 喉镜，131：E1443-E1449，2021.
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