CUNY School of Public Health & Health Policy, New York, NY, USA.
D. Samuel Gottesman Library, The Albert Einstein College of Medicine, Bronx, New York, USA.
J Health Commun. 2023 Mar 4;28(3):190-204. doi: 10.1080/10810730.2023.2192014. Epub 2023 Mar 28.
Growing evidence shows there is heterogeneity in patient communication preferences and a need to tailor communication approaches accordingly. However, little is known about the psychosocial factors that influence communication preferences. Among them is locus of control (LOC), a belief about who or what determines outcomes, including health. Although LOC theory was developed over 60 years ago as a personality theory, its relevance in healthcare has increased over the past two decades. There is a paucity of empirical evidence on patient or provider LOC as it influences communication quality and outcomes in healthcare settings. We conducted a systematic review to collate the current state of the literature.We carried out a comprehensive search of PubMed MEDLINE, Embase, PsycInfo, and Cochrane Library databases to retrieve relevant peer-reviewed articles. A total of 1152 publications were identified. Our final review included 17 articles that underwent data extraction and quality assessment.The included studies found evidence of LOC associations with several patient and provider communication-related outcomes including satisfaction with care; medical decision-making and communication preferences; adherence; and patient-provider rapport. As opposed to generalized approaches to communication, assessing patient LOC may allow clinicians to tailor their approaches to match patients' LOC. Our findings provide a starting point and highlight the need for future studies.
越来越多的证据表明,患者的沟通偏好存在异质性,需要相应地调整沟通方法。然而,人们对影响沟通偏好的心理社会因素知之甚少。其中包括控制源(LOC),即关于谁或什么决定结果的信念,包括健康。尽管 LOC 理论是 60 多年前作为一种人格理论发展起来的,但在过去的二十年中,它在医疗保健中的相关性有所增加。关于患者或提供者 LOC 如何影响医疗保健环境中的沟通质量和结果的实证证据很少。我们进行了系统评价以汇集当前文献的状况。我们全面搜索了 PubMed MEDLINE、Embase、PsycInfo 和 Cochrane Library 数据库,以检索相关的同行评议文章。共确定了 1152 篇出版物。我们的最终综述包括 17 篇经过数据提取和质量评估的文章。纳入的研究发现,LOC 与包括对护理的满意度在内的几个与患者和提供者沟通相关的结果之间存在关联;医疗决策和沟通偏好;依从性;以及患者与提供者的融洽关系。与通用沟通方法不同,评估患者的 LOC 可能使临床医生能够根据患者的 LOC 调整他们的方法。我们的研究结果提供了一个起点,并强调了未来研究的必要性。