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重症监护病房中的沟通:一种意想不到的反安慰剂效应?

Communication in the ICU: An Unintended Nocebo Effect?

作者信息

Riestra Guiance Irene, Wallace Lindsey, Varga Katalin, Niven Alexander, Hosey Megan, Chitulangoma Jillene, Philbrick Kemuel, Gajic Ognjen, Weiman Madeline, Schmitt Emily, Pasko David, Karnatovskaia Lioudmila

机构信息

Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.

Department of Critical Care Multidisciplinary Program, Mayo Clinic, Rochester, MN, USA.

出版信息

J Patient Exp. 2024 Aug 9;11:23743735241272148. doi: 10.1177/23743735241272148. eCollection 2024.


DOI:10.1177/23743735241272148
PMID:39130130
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11311157/
Abstract

To identify medical phrases utilized by the critical care team that may have an unintended impact on the critically ill patient, we administered an anonymous survey to multi-professional critical care team members. We elicited examples of imprecise language that may have a negative emotional impact on the critically ill. Of the 1600 providers surveyed, 265 offered 1379 examples (912 unique) which were clustered into 5 categories. Medical jargon (eg, "riding the vent") was most prevalent (n = 549). There were 217 negative suggestions (eg, "you will feel a stick and a burn"). Hyperboles (eg, "black cloud") were common (n = 198) while homonyms (ie "he fibbed") accounted for 150 examples. Phrases such as "code brown in there" were categorized as metonyms (n = 144). 121 metaphors/similes (eg, "rearranging deck chairs on the Titanic") were provided. Phrases that have the potential to negatively impact critically ill patient perceptions are commonplace in critical care practice. Whether these everyday communication habits lead to an unintended nocebo effect on mental health outcomes of the critically ill deserves further study.

摘要

为了识别重症监护团队使用的可能对重症患者产生意外影响的医学用语,我们对多专业重症监护团队成员进行了一项匿名调查。我们收集了可能对重症患者产生负面情绪影响的不精确语言的例子。在接受调查的1600名医护人员中,265人提供了1379个例子(912个是独特的),这些例子被归为5类。医学术语(如“使用呼吸机”)最为常见(n = 549)。有217条负面表述(如“你会感到刺痛和灼烧”)。夸张说法(如“厄运”)很常见(n = 198),而同音异义词(如“他撒了谎”)占150个例子。诸如“那里发生棕色代码”这样的短语被归类为转喻(n = 144)。还提供了121个隐喻/明喻(如“在泰坦尼克号上重新布置折叠椅”)。有可能对重症患者认知产生负面影响的用语在重症监护实践中很常见。这些日常沟通习惯是否会对重症患者的心理健康结果产生意外的反安慰剂效应值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0046/11311157/26e9cb870b61/10.1177_23743735241272148-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0046/11311157/26e9cb870b61/10.1177_23743735241272148-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0046/11311157/26e9cb870b61/10.1177_23743735241272148-fig1.jpg

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[1]
Communication in the ICU: An Unintended Nocebo Effect?

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本文引用的文献

[1]
Unheard and unseen: The hidden impact of nocebo communication in the Intensive Care Unit.

J Intensive Care Soc. 2023-11-29

[2]
"Fighting the Ventilator": Abandoning Exclusionary Violence Metaphors in the Intensive Care Unit.

Ann Am Thorac Soc. 2023-11

[3]
Vagueness in Goals-of-Care Conferences for Critically Ill Patients: Types of Hedge Language Used by Physicians.

Crit Care Med. 2023-11-1

[4]
Jargon Be Gone - Patient Preference in Doctor Communication.

J Patient Exp. 2023-2-28

[5]
Negative language use of the physiotherapist in low back pain education impacts anxiety and illness beliefs: A randomised controlled trial in healthy respondents.

Patient Educ Couns. 2023-5

[6]
Effect of a repeated verbal reminder of orientation on emergence agitation after general anaesthesia for minimally invasive abdominal surgery: a randomised controlled trial.

Br J Anaesth. 2023-4

[7]
Accuracy in Patient Understanding of Common Medical Phrases.

JAMA Netw Open. 2022-11-1

[8]
Nocebo language in anaesthetic patient written information.

Anaesthesia. 2022-10

[9]
Just a smidge, or a bridge too far? Slang use in the ICU.

BMJ. 2021-12-16

[10]
Humanizing the ICU Patient: A Qualitative Exploration of Behaviors Experienced by Patients, Caregivers, and ICU Staff.

Crit Care Explor. 2021-6-15

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