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.
Psychol Med. 1995 Sep;25(5):1011-8. doi: 10.1017/s0033291700037508.
This study explored the changes in complaint-related cognitions and anxiety of 110 consecutive out-patients with functional abdominal complaints (irritable bowel syndrome), during a series of consultations. Patients' anxiety, fear of cancer, somatic attribution concerning intestines or stomach and catastrophizing cognitions appeared to diminish significantly during the consulting period. Positive changes in patients' psychological attribution and somatic attribution appeared to be related to doctors' correct perceptions of these attributions. Catastrophizing cognitions diminished significantly more when patients saw the same doctor throughout the consultations. As changes in attributions and catastrophizing cognitions appeared to be related to doctor-patient interaction, it is conceivable that doctors could learn to influence cognitions even more.
本研究探讨了110例连续性功能性腹部不适(肠易激综合征)门诊患者在一系列会诊过程中与主诉相关的认知及焦虑情绪的变化。在会诊期间,患者的焦虑、对癌症的恐惧、对肠道或胃部的躯体归因及灾难化认知似乎显著减轻。患者心理归因和躯体归因的积极变化似乎与医生对这些归因的正确认知有关。在整个会诊过程中由同一位医生诊治的患者,其灾难化认知的减轻更为显著。由于归因及灾难化认知的变化似乎与医患互动有关,可以想象医生能够学会更好地影响患者的认知。