{"title":"医疗失效:概念分析。","authors":"Yi-Wen Chen , Enyi Jen , Jaw-Shiun Tsai , Jen-Kuei Peng , Chia-Chun Tang","doi":"10.1016/j.pec.2025.109338","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to define and clarify the concept of medical invalidation.</div></div><div><h3>Methods</h3><div>Following Walker and Avant’s eight-step concept analysis approach, a systematic literature search was conducted in PubMed, Embase, CINAHL, and PsycINFO, covering studies published between 2005 and July 2025. The analysis identified the defining attributes, model and contrary cases, antecedents, consequences, and empirical referents.</div></div><div><h3>Results</h3><div>Twenty-nine articles published between 2009 and 2025 were included. Medical invalidation is defined as “a communication behavior or self-belief that undermines an individual’s perception and autonomy in relation to their illness.” The key attributes included a lack of understanding, discounting, and pathologizing. Antecedents can be categorized into disease-, patient-, and provider-related factors. The consequences span psychological, physical, health-related quality of life, behavior, social, and systemic domains.</div></div><div><h3>Conclusion</h3><div>Medical invalidation is a significant yet still-evolving concept in health communication with implications for patient- and system-level outcomes. Findings from this concept analysis provide a foundational understanding that may inform the development of future interventions aimed at addressing the antecedents and consequences of medical invalidation. By guiding such efforts, this work has the potential to support improvements in patient-provider interactions and, in turn, contribute to better patient well-being.</div></div><div><h3>Practice implications</h3><div>Recognizing and addressing medical invalidation can enhance patient-centered care, foster more effective health communication, and reduce negative health outcomes. By increasing awareness of invalidation, healthcare providers, educators, and policymakers can better support patients’ experiences, strengthen therapeutic relationships, and promote a more empathetic and inclusive clinical environment.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109338"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medical invalidation: A concept analysis\",\"authors\":\"Yi-Wen Chen , Enyi Jen , Jaw-Shiun Tsai , Jen-Kuei Peng , Chia-Chun Tang\",\"doi\":\"10.1016/j.pec.2025.109338\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>This study aimed to define and clarify the concept of medical invalidation.</div></div><div><h3>Methods</h3><div>Following Walker and Avant’s eight-step concept analysis approach, a systematic literature search was conducted in PubMed, Embase, CINAHL, and PsycINFO, covering studies published between 2005 and July 2025. The analysis identified the defining attributes, model and contrary cases, antecedents, consequences, and empirical referents.</div></div><div><h3>Results</h3><div>Twenty-nine articles published between 2009 and 2025 were included. Medical invalidation is defined as “a communication behavior or self-belief that undermines an individual’s perception and autonomy in relation to their illness.” The key attributes included a lack of understanding, discounting, and pathologizing. Antecedents can be categorized into disease-, patient-, and provider-related factors. The consequences span psychological, physical, health-related quality of life, behavior, social, and systemic domains.</div></div><div><h3>Conclusion</h3><div>Medical invalidation is a significant yet still-evolving concept in health communication with implications for patient- and system-level outcomes. Findings from this concept analysis provide a foundational understanding that may inform the development of future interventions aimed at addressing the antecedents and consequences of medical invalidation. By guiding such efforts, this work has the potential to support improvements in patient-provider interactions and, in turn, contribute to better patient well-being.</div></div><div><h3>Practice implications</h3><div>Recognizing and addressing medical invalidation can enhance patient-centered care, foster more effective health communication, and reduce negative health outcomes. By increasing awareness of invalidation, healthcare providers, educators, and policymakers can better support patients’ experiences, strengthen therapeutic relationships, and promote a more empathetic and inclusive clinical environment.</div></div>\",\"PeriodicalId\":49714,\"journal\":{\"name\":\"Patient Education and Counseling\",\"volume\":\"141 \",\"pages\":\"Article 109338\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Patient Education and Counseling\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0738399125007050\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Patient Education and Counseling","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0738399125007050","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
This study aimed to define and clarify the concept of medical invalidation.
Methods
Following Walker and Avant’s eight-step concept analysis approach, a systematic literature search was conducted in PubMed, Embase, CINAHL, and PsycINFO, covering studies published between 2005 and July 2025. The analysis identified the defining attributes, model and contrary cases, antecedents, consequences, and empirical referents.
Results
Twenty-nine articles published between 2009 and 2025 were included. Medical invalidation is defined as “a communication behavior or self-belief that undermines an individual’s perception and autonomy in relation to their illness.” The key attributes included a lack of understanding, discounting, and pathologizing. Antecedents can be categorized into disease-, patient-, and provider-related factors. The consequences span psychological, physical, health-related quality of life, behavior, social, and systemic domains.
Conclusion
Medical invalidation is a significant yet still-evolving concept in health communication with implications for patient- and system-level outcomes. Findings from this concept analysis provide a foundational understanding that may inform the development of future interventions aimed at addressing the antecedents and consequences of medical invalidation. By guiding such efforts, this work has the potential to support improvements in patient-provider interactions and, in turn, contribute to better patient well-being.
Practice implications
Recognizing and addressing medical invalidation can enhance patient-centered care, foster more effective health communication, and reduce negative health outcomes. By increasing awareness of invalidation, healthcare providers, educators, and policymakers can better support patients’ experiences, strengthen therapeutic relationships, and promote a more empathetic and inclusive clinical environment.
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.