医疗失效:概念分析。

IF 3.1 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Yi-Wen Chen , Enyi Jen , Jaw-Shiun Tsai , Jen-Kuei Peng , Chia-Chun Tang
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引用次数: 0

摘要

目的:对医疗无效的概念进行界定和澄清。方法:采用Walker和Avant的八步概念分析方法,在PubMed、Embase、CINAHL和PsycINFO等数据库中进行系统的文献检索,检索时间为2005年至2025年7月。分析确定了定义属性、模型和相反的案例、前因、后果和经验参照。结果:纳入2009 - 2025年间发表的29篇文献。医学无效被定义为“一种破坏个人对疾病的感知和自主的沟通行为或自我信念”。关键的特征包括缺乏理解、轻视和病态化。前因可分为疾病相关因素、患者相关因素和提供者相关因素。其后果跨越心理、身体、健康相关的生活质量、行为、社会和系统领域。结论:医疗无效是一个重要的,但仍在发展的概念,在卫生沟通与影响患者和系统层面的结果。这一概念分析的结果提供了一种基本的理解,可为今后制定旨在处理医疗失效的前因后果的干预措施提供信息。通过指导这些努力,这项工作有可能支持改善患者与提供者的互动,从而有助于改善患者的健康状况。实践启示:认识和解决医疗失效可以加强以患者为中心的护理,促进更有效的健康沟通,并减少负面的健康结果。通过提高对无效的认识,医疗保健提供者、教育工作者和政策制定者可以更好地支持患者的体验,加强治疗关系,并促进更具同理心和包容性的临床环境。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medical invalidation: A concept analysis

Objective

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.
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来源期刊
Patient Education and Counseling
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.
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