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相互独立但又相互关联:日间肿瘤治疗单元中医护人员社会支持的维度

Separate but Related: Dimensions of Healthcare Provider Social Support in Day-Treatment Oncology Units.

作者信息

Tomai Manuela, Lauriola Marco

机构信息

Department of Dynamic and Clinical Psychology, and Health, Sapienza University of Rome, Rome, Italy.

Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy.

出版信息

Front Psychol. 2022 Apr 22;13:773447. doi: 10.3389/fpsyg.2022.773447. eCollection 2022.

Abstract

Social support by healthcare providers has been increasingly investigated during the past decade, but studies have made different choices concerning its measurement. To evaluate how social support from a healthcare provider impacts the perceived quality of care and patient outcomes, reliable and valid instruments capable of measuring specific aspects of the construct are needed. In study 1, we tested the factor structure and the psychometric properties of a new Healthcare Provider Social Support measure (HPSS) for oncology settings. One-hundred-sixty-two patients (89 females; age = 58.97, age = 13.28) from religious and government-operated hospitals completed the HPSS during day treatment. We modeled the HPSS factor structure to represent four related aspects: Emotional, Informational, Appraisal, and Instrumental social support. Study 2 preliminarily assessed the concurrent validity of the HPSS with patient perceptions of the patient-doctor relationship. Sixty-nine patients (40 females; age = 53.67, age = 13.74) completed the HPPS with scales assessing perceived doctor-patient communication and patient trust in the healthcare provider. Study 1, using Exploratory Structural Equation Modeling, showed that a bifactor model had an excellent fit. The analysis supported the use of subscale scores, which were more tenable than a single total score in terms of bifactor model indices. This conclusion was also supported by greater scalability of the subscales in a Mokken Scale Analysis. Oncology patients treated in the religious hospital perceived greater Emotional, Informational, and Instrumental social support from their healthcare provider than those treated in government-operated. Study 2 showed that patient ratings of healthcare provider social support, except Instrumental, were positively correlated with better doctor communication skills and greater trust in the physician. Multiple regression analyses showed that Informational and Emotional support provided a unique contribution to building trust in the physician, controlling for the doctor's communication skills. The study results showed that the four social support ratings were reliable and valid, sharpening the distinction between functional components in the formal healthcare system.

摘要

在过去十年中,医疗服务提供者的社会支持受到了越来越多的研究,但各项研究在其测量方法上做出了不同选择。为了评估医疗服务提供者的社会支持如何影响患者对医疗质量的感知以及患者的治疗结果,需要有可靠且有效的工具来测量该结构的特定方面。在研究1中,我们测试了一种用于肿瘤学环境的新型医疗服务提供者社会支持量表(HPSS)的因子结构和心理测量特性。来自宗教医院和政府运营医院的162名患者(89名女性;年龄 = 58.97,标准差 = 13.28)在日间治疗期间完成了HPSS量表。我们对HPSS的因子结构进行建模,以代表四个相关方面:情感、信息、评估和工具性社会支持。研究2初步评估了HPSS与患者对医患关系的感知之间的同时效度。69名患者(40名女性;年龄 = 53.67,标准差 = 13.74)完成了HPPS量表以及评估医患沟通感知和患者对医疗服务提供者信任程度的量表。研究1使用探索性结构方程模型表明,双因子模型具有良好的拟合度。分析支持使用子量表分数,就双因子模型指标而言,子量表分数比单一总分更具合理性。莫肯量表分析中各子量表更高的可扩展性也支持了这一结论。在宗教医院接受治疗的肿瘤患者比在政府运营医院接受治疗的患者感受到医疗服务提供者给予的更多情感、信息和工具性社会支持。研究2表明,除工具性支持外,患者对医疗服务提供者社会支持的评分与更好的医生沟通技巧和对医生更高的信任度呈正相关。多元回归分析表明,在控制医生沟通技巧的情况下,信息支持和情感支持对建立对医生信任有独特贡献。研究结果表明,这四项社会支持评分是可靠且有效的,明确了正式医疗系统中功能组成部分之间的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9b2/9072867/a1c8dca110b9/fpsyg-13-773447-g001.jpg

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