van Dulmen A M, Fennis J F, Mokkink H G, van der Velden H G, Bleijenberg G
Department of General Practice and Social Medicine, University of Nijmegen, The Netherlands.
J Psychosom Res. 1994 Aug;38(6):581-90. doi: 10.1016/0022-3999(94)90055-8.
Functional abdominal complaints (IBS) are widespread in the general population, especially among women. Non-organic dimensions of the complaint such as complaint-related cognitions and behaviour appear to be related to the prognosis. The prognosis could possibly be improved by changing these factors during medical consultations. Therefore, doctors have to perceive patients' cognitions and behaviour. But, do they perceive them correctly? One hundred and twenty patients with functional abdominal complaints referred to an out-patient clinic for internal medicine completed a questionnaire about their complaints and their complaint-related cognitions, behaviour, and anxiety prior to the first consultation. After the first consultation, doctors completed a similar questionnaire indicating their perceptions of patients' cognitions, anxiety, behaviour, and complaints. Complaints were perceived better than cognitions, anxiety, and behaviour. Doctors underestimated patients' expectations and secondary complaints and overestimated patients' pain-related attributions, and their catastrophizing and self-efficacy cognitions.
功能性腹部疾病（肠易激综合征）在普通人群中很常见，尤其是在女性中。该疾病的非器质性方面，如与疾病相关的认知和行为，似乎与预后有关。在医疗咨询过程中改变这些因素可能会改善预后。因此，医生必须了解患者的认知和行为。但是，他们的认知是否正确呢？120名因功能性腹部疾病到内科门诊就诊的患者在首次咨询前完成了一份关于他们的疾病、与疾病相关的认知、行为和焦虑的问卷。首次咨询后，医生完成了一份类似的问卷，表明他们对患者认知、焦虑、行为和疾病的看法。医生对疾病的认知比对认知、焦虑和行为的认知更好。医生低估了患者的期望和继发性疾病，高估了患者与疼痛相关的归因、灾难化思维和自我效能感认知。
