Challenges to physician-patient communication about medication use: a window into the skeptical patient's world.
Challenges to physician-patient communication about medication use: a window into the skeptical patient's world.
复制标题
医师与患者有关用药的沟通的挑战：进入持怀疑态度患者世界的窗口。
DOI：
10.2147/ppa.s25971
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发表时间：
2012
影响因子：
2.2
通讯作者：
Wilson IB
中科院分区：
文献类型：
--
作者：
Bezreh T;Laws MB;Taubin T;Rifkin DE;Wilson IB
患者经常不按照处方服药，并且经常不与医生沟通他们的服药行为。 “以患者为中心”的护理运动导致这一问题从“不依从”重新贴上“不依从”的标签，后来又出现了“一致”和“共同决策”的说法，其中医生和患者被视为理想的合作伙伴，在适当的治疗方面达成一致。我们对《纽约时报》一篇关于药物依从率低的文章的在线评论进行了定性内容分析。在线讨论提供了有关经过精心挑选、受过教育的患者样本如何看待药物使用和医患关系的数据。我们的分析揭示了患者的赋权和自力更生、对药物和医疗实践的极大不信任，以及对药物依从性问题的频繁不沟通。我们讨论了如何参考哈贝马斯的沟通行为理论来理解这些观察结果，并得出结论，医生可以从更好地理解一些患者对医生处方实践的负面看法中受益。
Patients frequently do not take medicines as prescribed and often do not communicate with their physicians about their medication-taking behavior. The movement for “patient-centered” care has led to relabeling of this problem from “noncompliance” to “nonadherence” and later to a rhetoric of “concordance” and “shared decision making” in which physicians and patients are viewed as partners who ideally come to agreement about appropriate treatment. We conducted a qualitative content analysis of online comments to a New York Times article on low rates of medication adherence. The online discussion provides data about how a highly selected, educated sample of patients thinks about medication use and the doctor–patient relationship. Our analysis revealed patient empowerment and self-reliance, considerable mistrust of medications and medical practice, and frequent noncommunication about medication adherence issues. We discuss how these observations can potentially be understood with reference to Habermas’s theory of communicative action, and conclude that physicians can benefit from better understanding the negative ways in which some patients perceive physicians’ prescribing practices.