Patients whom neurologists find difficult to help
Patients whom neurologists find difficult to help
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DOI：
10.1136/jnnp.2003.032169
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发表时间：
2004-12-01
影响因子：
11
通讯作者：
Sharpe, M
中科院分区：
文献类型：
--
作者：
Carson, AJ;Stone, J;Sharpe, M
背景资料：所有的医生都认识到，有些病人比其他病人更“难以帮助”，但这个问题在神经病学实践中几乎没有得到系统的调查。目的：检验一个假设，即那些症状较少被器质性疾病解释的病人会被认为更难帮助。方法：在连续的300名新的神经科门诊病人中，神经学家在四点Likert型量表上指出，“很难帮助”，他们发现了病人，病人的症状在多大程度上可以用器质性疾病来解释。患者的人口统计学，健康状况，躯体症状的数量，和精神状态也assessed.Results：神经科医生评为143例（48%）为“不是在所有困难”的帮助，111（37%）为“有点困难”，27（9%）为“非常困难”，18（6%）为“非常困难”。一个逻辑回归模型的构建和假设，即病人的症状是有机疾病的解释将被视为更难帮助的支持。唯一的其他测量变量，有助于感知困难是身体残疾，但它只解释了一小部分的variation.Conclusions：神经科医生发现患者的症状不解释器质性疾病更难帮助比其他患者。
Background: All doctors recognise that some patients are more "difficult to help'' than others, but the issue has received little systematic investigation in neurological practice.Objective: To test the hypothesis that patients whose symptoms were less explained by organic disease would be perceived as more difficult to help.Methods: In a consecutive series of 300 new neurology outpatients, neurologists indicated on four point Likert-type scales how "difficult to help'' they found the patient and to what extent the patient's symptoms were explained by organic disease. The patients' demographics, health status, number of somatic symptoms, and mental state were also assessed.Results: The neurologists rated 143 patients (48%) as "not at all difficult'' to help, 111 (37%) as "somewhat difficult'', 27 (9%) as 'very difficult'', and 18 (6%) as 'extremely difficult''. A logistic regression model was constructed and the hypothesis that patients whose symptoms were less explained by organic disease would be perceived as more difficult to help was supported. The only other measured variable that contributed to perceived difficulty was physical disability, but it explained only a small amount of the variance.Conclusions: Neurologists find patients whose symptoms are not explained by organic disease more difficult to help than their other patients.