Street R L, Gold W R, McDowell T
Institute for Health Care Evaluation, Texas A&M University Health Sciences Center, College Station 77843-4234.
Med Care. 1994 Jul;32(7):732-44. doi: 10.1097/00005650-199407000-00006.
The goal of this research was to identify patients' preferences for physician inquiry into various aspects of health status and to examine whether the preconsultation availability of health status data (collected from the SF-36 Health Status Questionnaire) influenced the physician's conduct during the consultation. Results from 58 prenatal patient visits yielded the following findings. First, patients expressed strong preferences for physicians to ask about the patient's perceptions of health in general and about physical dimensions of health status such as pain, vitality, and role limitations due to physical functioning. Patients also were more satisfied when doctors were perceived as having asked about these issues. Second, patients varied considerably in their preferences for physician inquiries into psychosocial issues such as social functioning, mental health, and role limitations due to emotional problems. Approximately half the patients wanted these matters discussed, whereas the remainder either did not care or preferred that doctors not ask about these topics. Third, the preconsultation availability of health status information had little effect on the degree to which physicians asked about the patient's health-related quality of life. Clinical implications are discussed.
本研究的目的是确定患者对于医生询问健康状况各个方面的偏好,并考察健康状况数据(从SF-36健康状况调查问卷收集)在会诊前的可得性是否会影响医生在会诊期间的行为。58次产前患者会诊的结果得出了以下发现。首先,患者强烈希望医生询问患者对总体健康的看法以及健康状况的身体方面,如疼痛、活力和由于身体功能导致的角色受限。当患者感觉医生询问了这些问题时,他们也会更满意。其次,患者对于医生询问心理社会问题(如社会功能、心理健康和由于情感问题导致的角色受限)的偏好差异很大。大约一半的患者希望讨论这些问题,而其余患者要么不在乎,要么更希望医生不要询问这些话题。第三,健康状况信息在会诊前的可得性对医生询问患者健康相关生活质量的程度影响很小。文中讨论了临床意义。