On being on the same page: Predictors of gastroenterologist-patient misalignment in inflammatory bowel disease

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2024-10-28 DOI:10.1016/j.pec.2024.108487

Neda Karimi , Alison R. Moore , Ashleigh Jones , Annabelle Lukin , Joseph L. Pipicella , Astrid-Jane Williams , Watson Ng , Ria Kanazaki , Viraj Kariyawasam , Nikola Mitrev , Keval Pandya , Jane M. Andrews , Susan J. Connor

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引用次数: 0

Abstract

Objectives

This study explored the prevalence and degree of misalignment between gastroenterologists and people with inflammatory bowel disease (IBD) and investigated communication features related to misalignment.

Methods

A mixed-methods approach incorporated qualitative and quantitative analyses of consultations and post-consultation patient and doctor interviews. Gastroenterologists at two Australian teaching hospitals and IBD patients participated in this study. Doctor-patient misalignment about topics discussed in consultations was quantified using patient and doctor interviews. Predictors of misalignment were hypothesised through a linguistic analysis of consultations and tested quantitatively.

Results

Data from 69 patients and seven gastroenterologists showed that consultation participants had different perceptions about at least one aspect of care in 36 % of the consultations. Predictors of misalignment included missing the opportunity to clarify an issue or concern and missing the opportunity to explain the rationale for a diagnosis or recommendation.

Conclusion

Staying on the topic until the patient is ready to move on and using so-called related messages in questions and explanations increases the likelihood of doctor-patient alignment.

Practice implications

Generic and IBD-specific clinician- and patient-targeted interventions should cover strategies for adequately discussing patients’ issues and concerns and clinicians’ clinical reasoning. These strategies should also be considered in designing health promotion activities.

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在同一起跑线上：炎症性肠病中胃肠病医生与患者意见不一致的预测因素

本研究探讨了胃肠病学家与炎症性肠病（IBD）患者之间沟通不畅的发生率和程度，并调查了与沟通不畅有关的沟通特征。方法采用混合方法，对咨询和咨询后的患者与医生访谈进行定性和定量分析。澳大利亚两家教学医院的消化科医生和 IBD 患者参与了这项研究。通过对患者和医生进行访谈，量化了医患双方在会诊中讨论的主题不一致的情况。来自 69 名患者和 7 名胃肠病专家的数据显示，在 36% 的会诊中，会诊参与者对至少一个方面的护理有不同看法。不一致的预测因素包括错过了澄清问题或疑虑的机会，以及错过了解释诊断或建议理由的机会。结论在患者准备好继续讨论之前，不要离开主题，并在问题和解释中使用所谓的相关信息，可增加医患一致的可能性。在设计健康促进活动时也应考虑这些策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.