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“或许我们正在忽视人性层面”——医生对慢性疼痛或多发性硬化症患者存在、精神及宗教需求的处理方式。一项质性访谈研究。

'Maybe we are losing sight of the human dimension' - physicians' approaches to existential, spiritual, and religious needs among patients with chronic pain or multiple sclerosis. A qualitative interview-study.

作者信息

Andersen Aida Hougaard, Assing Hvidt Elisabeth, Hvidt Niels Christian, Roessler Kirsten K

机构信息

Department of Psychology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark.

Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.

出版信息

Health Psychol Behav Med. 2020 Jul 23;8(1):248-269. doi: 10.1080/21642850.2020.1792308.

Abstract

OBJECTIVE

Research suggests that existential, spiritual, and religious issues are important for patient's psychological adjustment when living with chronic pain and multiple sclerosis. However, there is a paucity of studies investigating how physicians experience and approach these patients' needs.

DESIGN

Physicians' experiences with and approaches to existential, spiritual, and religious needs when treating chronic pain or multiple sclerosis were studied in eight semi-structured interviews and analysed using interpretative phenomenological analysis (IPA).

RESULTS

Physicians found that only few patients had spiritual and religious needs; however, they experienced that every patient were struggling with existential challenges related to the illness and rooted in a changed identity and approaching death. How the physicians approached these needs appeared to be influenced by six conditions: Their medical culture, training, role, experiences of time pressure, their personal interests, and interpersonal approach.

CONCLUSION

Physicians' training seems better suited to meet biomedical objectives and their patients' concrete needs than patients' wish for a relational meeting focused on their subjective lifeworld. This challenge is discussed in relation to modern patient-centeredness, doctor-patient relationship, culturally constructed experiences of privacy, and future clinical practice and research needs.

摘要

目的

研究表明,存在、精神和宗教问题对于慢性疼痛和多发性硬化症患者的心理调适至关重要。然而,鲜有研究调查医生如何体验并满足这些患者的需求。

设计

通过八次半结构化访谈,研究医生在治疗慢性疼痛或多发性硬化症时对患者存在、精神和宗教需求的体验及应对方式,并采用解释现象学分析(IPA)进行分析。

结果

医生发现只有少数患者有精神和宗教需求;然而,他们体会到每个患者都在与与疾病相关的存在挑战作斗争,这些挑战源于身份的改变和对死亡的临近。医生应对这些需求的方式似乎受到六个条件的影响:他们的医学文化、培训、角色、时间压力体验、个人兴趣和人际沟通方式。

结论

与患者希望进行专注于其主观生活世界的关系性会面相比,医生的培训似乎更适合满足生物医学目标和患者的具体需求。结合现代以患者为中心的理念、医患关系、文化建构的隐私体验以及未来临床实践和研究需求,对这一挑战进行了讨论。

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