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医患沟通影响溃疡性结肠炎患者治疗决策中的患者满意度:基于网络的问卷调查的结构方程模型分析。

Physician-patient communication affects patient satisfaction in treatment decision-making: a structural equation modelling analysis of a web-based survey in patients with ulcerative colitis.

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan.

Teikyo University Graduate School of Public Health, Tokyo, Japan.

出版信息

J Gastroenterol. 2021 Sep;56(9):843-855. doi: 10.1007/s00535-021-01811-1. Epub 2021 Jul 27.

Abstract

BACKGROUND

The relationship of bidirectional sharing of information between physicians and patients to patient satisfaction with treatment decision-making for ulcerative colitis (UC) has not been examined. Here, we conducted a web-based survey to evaluate this relationship.

METHODS

Patients aged ≥ 20 years with UC were recruited from the IBD Patient Panel and Japanese IBD Patient Association. Patients completed our web-based survey between 11 May and 1 June 2020. The main outcomes were patient satisfaction (assessed by the Decision Regret Scale) and patient trust in physicians (assessed by the Trust in Physician Scale).

RESULTS

In this study (n = 457), a structural equation modelling analysis showed that physician-to-patient and patient-to-physician information significantly affected patient satisfaction with treatment decision-making (standardised path coefficient: 0.426 and 0.135, respectively) and patient trust in physicians (0.587 and 0.158, respectively). Notably, physician-to-patient information had a greater impact. For patient satisfaction with treatment decision-making and patient trust in physicians, information on "disease" (indirect effect: 0.342 and 0.471, respectively), "treatment" (0.335 and 0.461, respectively), and "endoscopy" (0.295 and 0.407, respectively) was particularly important, and the level of this information was adequate or almost adequate. Patient-to-physician information on "anxiety and distress" (0.116 and 0.136, respectively), "intention and desire for treatment" (0.113 and 0.132, respectively), and "future expectations of life" (0.104 and 0.121, respectively) were also important for patient satisfaction with treatment decision-making and patient trust in physicians, but these concerns were not adequately communicated.

CONCLUSIONS

Adequate physician-patient communication, especially physician-to-patient information, enhanced patient satisfaction with treatment decision-making for UC.

摘要

背景

医患之间双向信息共享与溃疡性结肠炎(UC)患者对治疗决策的满意度之间的关系尚未得到检验。在此,我们进行了一项网络调查来评估这种关系。

方法

从 IBD 患者小组和日本 IBD 患者协会招募年龄≥20 岁的 UC 患者。患者于 2020 年 5 月 11 日至 6 月 1 日之间完成我们的网络调查。主要结局是患者对治疗决策的满意度(通过决策后悔量表评估)和对医生的信任(通过信任医生量表评估)。

结果

在这项研究中(n=457),结构方程模型分析表明,医患之间的信息显著影响患者对治疗决策的满意度(标准化路径系数分别为 0.426 和 0.135)和对医生的信任(0.587 和 0.158)。值得注意的是,医患之间的信息具有更大的影响。对于治疗决策的满意度和对医生的信任,关于“疾病”(间接影响分别为 0.342 和 0.471)、“治疗”(0.335 和 0.461)和“内镜检查”(0.295 和 0.407)的信息尤为重要,且这些信息的水平是足够的或几乎足够的。患者向医生提供的关于“焦虑和痛苦”(0.116 和 0.136)、“治疗意向和愿望”(0.113 和 0.132)和“对未来生活的期望”(0.104 和 0.121)的信息对治疗决策的满意度和对医生的信任也很重要,但这些关注点没有得到充分沟通。

结论

充分的医患沟通,特别是医患之间的信息交流,增强了 UC 患者对治疗决策的满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7428/8370900/9a64c9a68a08/535_2021_1811_Fig1_HTML.jpg

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