Brown R, Dunn S, Butow P
Department of Psychological Medicine, University of Sydney, Camperdown NSW, Australia.
Ann Oncol. 1997 Sep;8(9):877-82. doi: 10.1023/a:1008213630112.
Low scores on satisfaction measures may be anticipated when patients' expectations of the doctor are unmet during the cancer consultation. We correlated discrepancies between patient expectations of their ideal doctor and their perceptions of their actual doctor with scores on a validated satisfaction scale to determine whether patients whose expectations were unmet were less satisfied.
The expectations questionnaire used a forced choice method designed to elicit patient preferences for either emotional or informational support from the physician. One hundred and five new patients with heterogeneous cancers, of five medical oncologists at a major teaching hospital were sampled. The patients were mostly female (55%) middle aged (mean age 54.3) and newly diagnosed with cancer (56% within two months prior to consultation).
Patients did not demonstrate a clear preference for an emotionally or informationally supportive approach. Seventy percent of patients did not want emotionally negative physicians but most (88.4%) would tolerate negative information. The mean number of exact matches between patients expectations of the ideal and their perceptions of their actual doctor was 3.7 (from a total of six). 5.9% of patients received exactly the doctor they wanted. No significant differences in satisfaction were found between patients whose expectations were met and those whose expectations were not met.
Patient satisfaction with the consultation was independent of patient expectation for informational or emotional support.
在癌症会诊期间，如果患者对医生的期望未得到满足，那么满意度测评得分可能会较低。我们将患者对理想医生的期望与对实际医生的认知之间的差异，与经过验证的满意度量表得分进行关联分析，以确定期望未得到满足的患者是否满意度较低。
期望问卷采用强制选择法，旨在引出患者对医生情感支持或信息支持的偏好。对一家大型教学医院的五位肿瘤内科医生的105例患有不同类型癌症的新患者进行了抽样。患者大多为女性（55%），中年（平均年龄54.3岁），且为新诊断出癌症（56%在会诊前两个月内确诊）。
患者对于情感支持或信息支持的方法没有表现出明确的偏好。70%的患者不希望医生在情感上消极，但大多数患者（88.4%）能够接受负面信息。患者对理想医生的期望与对实际医生的认知之间完全匹配的平均数量为3.7（总共六项）。5.9%的患者得到了他们想要的医生。期望得到满足的患者和期望未得到满足的患者在满意度上没有显著差异。
患者对会诊的满意度与患者对信息支持或情感支持的期望无关。
