Introducing the System for Observing Medical Alliances (SOMA): A Tool for Studying Concordance in Patient-Physician Relationships.

Introducing the System for Observing Medical Alliances (SOMA): A Tool for Studying Concordance in Patient-Physician Relationships.
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介绍医疗联盟观察系统 (SOMA):用于研究医患关系一致性的工具。

DOI:
10.1177/0011000019891434
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发表时间:
2019
期刊:
The Counseling psychologist
影响因子:
--
通讯作者:
McAndrew,LisaM
McAndrew,LisaM
中科院分区:
--
文献类型:
--
作者:
Friedlander,MyrnaL;Kangos,Kelsey;Maestro,Kieran;Muetzelfeld,Hannah;Wright,ScottT;Silva,NicoleDa;Kimber,Justin;Helmer,DrewA;McAndrew,LisaM

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我们开发了医疗联盟观察系统(索马)来研究医疗服务提供者与出现医学上无法解释的症状(MUS)的患者之间的关系。基于健康心理学,医学和心理治疗联盟的文献,索马实施了三个医疗联盟维度:参与咨询过程,对提供者的信任,以及疾病信念和治疗建议的一致性。具体的行为指标,由受过训练的法官观察,作为评级的基础,每一个方面。在33名患有MUS的退伍军人的医疗咨询样本中,评估者之间的可靠性范围为0.79至0.94。值得注意的是,其他方面的评级占40%的一致性的变化,在供应商的信任贡献独特的方差。除了研究之外,综合健康环境中的心理学家可以使用索马咨询和培训医疗提供者的沟通技巧,以提高一致性。
We developed the System for Observing Medical Alliances (SOMA) to study relationships between medical providers and patients with medically unexplained symptoms (MUS). Based on literature in health psychology, medicine, and the psychotherapeutic alliance, the SOMA operationalizes three medical alliance dimensions: Engagement in the Consultation Process, Trust in the Provider, and Concordance of Illness Beliefs and Treatment Recommendations. Specific behavioral indicators, tallied as observed by trained judges, are used as the basis for rating each dimension. In a sample of 33 medical consultations with veterans who had MUS, interrater reliabilities ranged from .79 to .94. Notably, the other dimension ratings accounted for 40% of the variability in Concordance, with Trust in the Provider contributing unique variance. In addition to research, psychologists in integrated health settings can use the SOMA to consult and train medical providers on communication skills that enhance concordance.
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