Sonino N, Fava G A, Aron D C, Guidi Jenny
Department of Statistical Sciences, University of Padova, Padova, Italy.
Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA.
J Endocrinol Invest. 2025 Mar 29. doi: 10.1007/s40618-025-02565-w.
Interviewing is a basic, yet neglected clinical method that allows to understand how a person feels and what are the presenting complaints, obtain medical history, assess personal attitudes and behavior related to health and disease. In the endocrine setting it provides the patient with information about diagnosis, prognosis and treatment, and establishes a therapeutic relationship that is crucial for shared decision making and self-management. However, the value of this clinical skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness. Instead, the time spent to enquire about problems and life setting may actually help to avoid further testing, procedures and referrals.
The aim of this paper is to provide an overview of optimal use of interviewing in clinical endocrinology.
The basic principles of the art of interviewing are described, particularly as to medical diagnosis and history, health attitudes and behavior (including lifestyle), patient's experience of symptoms and quality of life, allostatic load and psychological distress.
Assessment by interviewing may indeed offer a characterization of the person's psychosocial environment that is missing from current formulations. It may shed light on a number of clinical issues, such as interpretation by the endocrinologist of abnormal hormone values that lack explanation, difficulties in coping with the various phases of illness, maladaptive illness behavior, presence of residual symptoms.
问诊是一种基本但常被忽视的临床方法，它能让人了解一个人的感受、当前的主诉，获取病史，评估与健康和疾病相关的个人态度及行为。在内分泌科环境中，它能为患者提供有关诊断、预后和治疗的信息，并建立一种对共同决策和自我管理至关重要的治疗关系。然而，这项临床技能的价值受到时间压力和对技术的重视的威胁。当前的医疗保健趋势倾向于昂贵的检查和程序，并将花在与患者互动上的时间标记为缺乏成本效益。相反，花时间询问问题和了解生活背景实际上可能有助于避免进一步的检查、程序和转诊。
本文的目的是概述问诊在临床内分泌学中的最佳应用。
描述了问诊艺术的基本原则，特别是关于医学诊断和病史、健康态度和行为（包括生活方式）、患者的症状体验和生活质量、应激负荷和心理困扰。
通过问诊进行评估确实可以提供对一个人的心理社会环境的描述，而这是当前表述中所缺失的。它可能会阐明一些临床问题，例如内分泌学家对缺乏解释的异常激素值的解读、应对疾病各个阶段的困难、适应不良的疾病行为、残留症状的存在。
