Local Health Unit Tuscany South-East, 53100 Siena, Italy.
Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy.
Int J Environ Res Public Health. 2022 Jan 21;19(3):1201. doi: 10.3390/ijerph19031201.
The relationship between general practitioners and patients is privileged. The aim of this study was to assess the concordance between the health profile perceived by the patient and the one described by the doctor. We conducted a cross-sectional study between 2019-2020. Patients completed the 5d-5L (EQ-p) and clinicians completed it "from the patient's perspective" (EQ-d), also consulting the clinical diary. Statistical analysis was performed using Stata 14 (Cohen's kappa; Fisher's exact test). The sample consisted of 423 patients. The mean age was 56.7 ± 19.2. There were significant differences by gender in usual activities, pain, and anxiety/depression (74.6% of men had no limitation in usual activities versus 64.5% of women ( < 0.01), 53.9% of men had no pain versus 38.5% of women ( < 0.01), and 60.3% of men had no anxiety/depression versus 38.5% of women ( < 0.01)). Physicians did not detect these differences. The concordance between EQ-p and EQ-d was substantial for mobility (k = 0.62; < 0.01), moderate for self-care (k = 0.48; < 0.01) and usual activities (k = 0.50; < 0.01). Concordance was fair for pain/discomfort (k = 0.32; < 0.01), anxiety/depression (k = 0.38; < 0.01), and EQ Index (k = 0.21; < 0.01). There was greater agreement for "objective "dimensions (mobility, self-care, and usual activities). A good doctor, to be considered as such, must try to put himself in the "patient's pajamas" to feel his feelings and be on the same wavelength.
医患关系是特权关系。本研究旨在评估患者感知的健康状况与医生描述的健康状况之间的一致性。我们在 2019-2020 年期间进行了一项横断面研究。患者填写 5d-5L（EQ-p），临床医生则从“患者视角”（EQ-d）填写，并查阅临床日记。使用 Stata 14 进行统计分析（Cohen's kappa；Fisher 确切检验）。样本包括 423 名患者。平均年龄为 56.7 ± 19.2 岁。在日常活动、疼痛和焦虑/抑郁方面，性别存在显著差异（74.6%的男性在日常活动中无受限，而女性为 64.5%（<0.01），53.9%的男性无疼痛，而女性为 38.5%（<0.01），60.3%的男性无焦虑/抑郁，而女性为 38.5%（<0.01））。然而，医生未能发现这些差异。EQ-p 与 EQ-d 在移动性方面具有高度一致性（k = 0.62；<0.01），在自我护理方面具有中度一致性（k = 0.48；<0.01），在日常活动方面具有中度一致性（k = 0.50；<0.01）。在疼痛/不适（k = 0.32；<0.01）、焦虑/抑郁（k = 0.38；<0.01）和 EQ 指数（k = 0.21；<0.01）方面具有一致性。“客观”维度（移动性、自我护理和日常活动）的一致性更高。一个好医生，要想被认为是好医生，就必须努力穿上“病人的睡衣”，感受病人的感受，与病人保持一致。
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