Department of Infectious Diseases, Tick-Borne Diseases Reference Center of Paris and the Northern Region, Centre Hospitalier Intercommunal de Villeneuve-Saint-Georges, 40 Allée de La Source, 94190, Villeneuve-Saint-Georges, France.
EpiMAI Research Unity, Laboratory of Animal Health, Anses-National Veterinary School of Alfort, 7 Av. du Général de Gaulle, 94700, Maisons-Alfort, France.
BMC Infect Dis. 2024 Mar 22;24(1):344. doi: 10.1186/s12879-024-09194-3.
To answer to patients' medical wandering, often due to "unexplained symptoms" of "unexplained diseases" and to misinformation, multidisciplinary care centers for suspected Lyme borreliosis (LB), such as the 5 Tick-Borne Diseases (TBDs) Reference Centers (TBD-RC), were created a few years ago in France, the Netherlands and Denmark. Our study consisted of a comprehensive analysis of the satisfaction of the patients managed at a TBD-RC for suspected LB in the context of scientific and social controversy.
We included all adults who were admitted to one of the TBD-RC from 2017 to 2020. A telephone satisfaction survey was conducted 12 months after their first consultation. It consisted of 5 domains, including 2 free-text items: "What points did you enjoy?" and "What would you like us to change or to improve?". In the current study, the 2 free-items were analyzed with a qualitative method called reflexive thematic analysis within a semantic and latent approach.
The answer rate was 61.3% (349/569) and 97 distinctive codes from the 2-free-text items were identified and classified into five themes: (1) multidisciplinarity makes it possible to set up quality time dedicated to patients; (2) multidisciplinarity enables seamless carepaths despite the public hospital crisis compounded by the COVID-19 pandemic; (3) multidisciplinarity is defined as trust in the team's competences; (4) an ambivalent opinion and uncertainty are barriers to acceptance of the diagnosis, reflecting the strong influence of the controversy around LB; and (5) a lack of adapted communication about TBDs, their management, and ongoing research is present.
The multidisciplinary management for suspected LB seemed an answer to medical wandering for the majority of patients and helped avoid misinformation, enabling better patient-centered shared information and satisfaction, despite the context of controversy.
为了回应患者因“不明原因疾病”的“不明原因症状”而产生的医学漫游，几年前在法国、荷兰和丹麦创建了多学科的莱姆病疑似患者护理中心（如 5 个蜱传疾病（TBDs）参考中心（TBD-RC））。我们的研究包括对在科学和社会争议背景下在 TBD-RC 接受疑似莱姆病管理的患者满意度进行全面分析。
我们纳入了所有 2017 年至 2020 年期间在 TBD-RC 就诊的成年人。在首次就诊后 12 个月进行了电话满意度调查。它包括 5 个领域，包括 2 个自由文本项：“您喜欢哪些方面？”和“您希望我们改变或改进什么？”。在本研究中，使用一种称为语义和潜在方法的反思性主题分析的定性方法对这 2 个自由项进行了分析。
应答率为 61.3%（349/569），从 2 个自由文本项中识别出 97 个独特代码，并分为五个主题：（1）多学科性使为患者设置专用高质量时间成为可能；（2）多学科性使无缝护理路径成为可能，尽管公共卫生危机因 COVID-19 大流行而加剧；（3）多学科性被定义为对团队能力的信任；（4）对诊断的矛盾意见和不确定性是接受诊断的障碍，反映了围绕 LB 的强烈争议的影响；（5）对 TBDs、其管理和正在进行的研究的适应性沟通不足。
多学科管理疑似 LB 似乎是大多数患者医学漫游的答案，并有助于避免错误信息，从而更好地实现以患者为中心的共享信息和满意度，尽管存在争议。
