How Successful Are Physicians in Eliciting the Truth From Their Patients? A Large-Scale Internet Survey From Patients' Perspectives
How Successful Are Physicians in Eliciting the Truth From Their Patients? A Large-Scale Internet Survey From Patients' Perspectives
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DOI：
10.4088/jcp.11m07078
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发表时间：
2012-03-01
影响因子：
5.3
通讯作者：
Mimura, Masaru
中科院分区：
文献类型：
--
作者：
Sawada, Norifusa;Uchida, Hiroyuki;Mimura, Masaru
目的：抑郁症患者如何诚实地向医生报告他们的症状和药物依从性还没有得到充分的解决。因此，我们进行了一次大规模的网络调查，试图发现医生如何成功地从病人那里引出真相，并研究病人隐瞒真相行为的原因。方法：通过筛选程序，从Macromill数据库的323226名登记者中确定了2354名在过去一年中接受过抑郁症治疗并通过患者健康问卷诊断为抑郁症的参与者。参与者被要求完成一份关于他们治疗抑郁症的问卷，特别关注医患关系。本研究于2010年12月7日至13日在日本进行。结果：2020名参与者成功完成问卷调查。总体而言，70.2%的应答者报告说他们对医生隐瞒了真相。逻辑回归模型发现，这种行为与女性（95% CI, 1.15-1.74； P=.001）、年龄较小（95% CI, 0.49-0.97； P=.030）和相互沟通满意度较低（95% Cl, 3.17-6.58; P < .001）有显著关联。69.2%的参与者和52.6%的参与者分别避免讲述他们的“日常活动”和“症状”。女性参与者更有可能隐瞒有关“遵守处方药物”和“体温和体重等数据”的事实。31.9%的参与者在没有咨询医生的情况下停止了治疗，这在女性、年轻人和与医生沟通不满意的人中再次更为常见。结论：虽然本文的发现需要在其他患者群体中得到重复，但大多数抑郁症患者不愿揭露真相，这强调了医生需要对症状和药物依从性进行更微调的怀疑。临床精神病学杂志2012；(C)版权所有2012年医师研究生出版社，Inc。
Objective: How honestly patients report their symptoms and medication adherence to their physicians has not been adequately addressed in patients with depression. We therefore conducted a large-scale Internet survey in an effort to discover how successful physicians are in eliciting the truth from their patients and also to examine reasons for patients' truth-concealing behaviors.Method: 2,354 participants who had received treatment for depression within the past year and had been diagnosed with depression by Patient Health Questionaire were identified from 323,226 registrants at the Macromill database through screening procedures. Participants were asked to complete a questionnaire regarding their treatment for depression with a special focus on patient-physician relationship. This study was conducted from December 7 to 13, 2010, in Japan.Results: 2,020 participants successfully completed the questionnaire. Overall, 70.2% of responders reported that they had withheld the truth from their physicians. A logistic regression model found significant associations of such a behavior with female sex (95% CI, 1.15-1.74; P=.001), younger age (95% CI, 0.49-0.97; P=.030), and a lower degree of satisfaction in mutual communication (95% Cl, 3.17-6.58; P < .001). 69.2% and 52.6% of the participants refrained from telling about their "daily activities"and "symptoms," respectively. Female participants were more likely to hide the facts concerning "adherence to prescribed medication" and "figures such as body temperature and weight." 31.9% of participants had discontinued the treatment without consulting their physician, which was again more frequent in females, younger persons, and those who were not satisfied with communication with their physician.Conclusions: While the findings obtained herein need to be replicated in other patient populations, a majority of patients with depression were reluctant to uncover the truth, which emphasizes the need for more fine-tuned suspicion among physicians about symptoms and medication adherence. J Clin Psychiatry 2012;73(3):311-317 (C) Copyright 2012 Physicians Postgraduate Press, Inc.