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医生和患者对高血压治疗方案依从性的判断。

Physicians' and patients' judgments of compliance with a hypertensive regimen.

作者信息

Rothert M L

出版信息

Med Decis Making. 1982;2(2):179-95. doi: 10.1177/0272989X8200200210.

Abstract

This study examines an early decision point in the process of compliance. Thirty primary care physicians and thirty outpatients responded to a series of written scenarios. These scenarios systematically incorporated four factors thought to affect adherence to a hypertensive regimen--convenience, cost, severity, and support. Data were analyzed using multiple regression and multivariate analysis of variance. A mean R2 was obtained of 0.70 for physicians and 0.58 for patients. In making these judgments, physicians and patients placed similar emphasis on cost, convenience, and severity, but physicians placed greater emphasis on support. There was a significant difference between the judgments of physicians and patients (p less than 0.0001). Patients tended to be more optimistic than physicians regarding adherence and put more importance on severity of illness than on support. These findings are useful to the clinician concerned with compliance and demonstrate the potential of this paradigm for research in clinical reasoning.

摘要

本研究考察了依从性过程中的一个早期决策点。30名初级保健医生和30名门诊患者对一系列书面情景做出了回应。这些情景系统地纳入了被认为会影响高血压治疗方案依从性的四个因素——便利性、成本、严重性和支持。使用多元回归和多变量方差分析对数据进行了分析。医生的平均R2为0.70,患者的平均R2为0.58。在做出这些判断时,医生和患者对成本、便利性和严重性的重视程度相似,但医生更强调支持。医生和患者的判断之间存在显著差异(p小于0.0001)。在依从性方面,患者往往比医生更乐观,并且更重视疾病的严重性而非支持。这些发现对关注依从性的临床医生很有用,并证明了这种范式在临床推理研究中的潜力。

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