McGaghie W C, Whitenack D C
J Nerv Ment Dis. 1982 Oct;170(10):598-604. doi: 10.1097/00005053-198210000-00003.
Physicians frequently use the term problem patient to subjectively label individuals who present with vague and shifting symptoms involving multiple organ systems, chronically complain, constantly worry about their health, and contribute in other ways to physician uncertainty and frustration. This article describes the development and reliability and validity studies of an instrument that objectively measures physicians' perceptions of problem patients. As such, the instrument quantifies a key qualitative impression that physicians may formulate. Use of the instrument in an ambulatory care setting yielded highly reliable data which, when subjected to correlation and regression analyses, display expected relationships with a parsimonious set of independent variables. We conclude that the instrument holds promise for further clinical and research work involving problem patients.
医生经常使用“问题患者”一词来主观地指代那些出现涉及多个器官系统的模糊且多变症状、长期抱怨、不断担心自己健康状况，并在其他方面导致医生产生不确定性和挫败感的个体。本文描述了一种客观测量医生对问题患者看法的工具的开发以及可靠性和有效性研究。因此，该工具量化了医生可能形成的一种关键定性印象。在门诊护理环境中使用该工具产生了高度可靠的数据，这些数据在进行相关性和回归分析时，与一组简洁的自变量呈现出预期的关系。我们得出结论，该工具在涉及问题患者的进一步临床和研究工作中具有前景。
