目的:晚期肺癌患者身体症状负担的增加会破坏患者的情绪健康,目前的文献表明,医生良好的沟通技巧可能是一个缓冲。然而,对于哪一组患者,这种缓冲作用最有效,我们知之甚少。基于对晚期肺癌患者的横断面研究,本研究调查了医师沟通技巧对身体症状和情绪困扰之间关联的调节作用是否进一步取决于患者对疾病的认知。
方法:晚期肺癌患者(n=199)填写了一份问卷,包括与肺癌相关的身体症状的测量,焦虑,和抑郁症状,对医生沟通技巧的看法,并自我报告了解他们的疾病。
结果:分层回归分析表明,身体症状之间存在显着的三向相互作用,对医生沟通技巧的看法,以及对焦虑和抑郁的感知疾病理解。具体来说,医生良好的沟通技巧仅对疾病理解水平较低的患者产生缓冲作用。
结论:我们的研究结果表明,对于疾病理解有限的患者,提高医生的沟通技巧可能对减少症状负担的适应不良情绪反应特别有益。当通信的时间和资源受到限制时,增强的意识和集中的培训可能旨在与对其疾病知识有限的患者进行沟通。
OBJECTIVE: The elevated physical symptom burden in advanced lung cancer can disrupt patients\' emotional well-being, and current literature suggests that physicians\' good communication skills might be a buffer. However, little is known about for which group of patients this buffering effect is most effective. Based on a cross-sectional study in patients with advanced lung cancer, the present study examined whether the moderating effect of physicians\' communication skills on the association between physical symptoms and emotional distress would further depend on patients\' perceived disease understanding.
METHODS: Patients with advanced lung cancer (n = 199) completed a questionnaire including measures of physical symptoms related to lung cancer, anxiety, and depressive symptoms, perceptions of physicians\' communication skills, and self-reported understanding of their disease.
RESULTS: Hierarchical regression analyses indicated a significant three-way interaction among physical symptoms, perceptions of physicians\' communication skills, and perceived disease understanding on both anxiety and depression. Specifically, physicians\' good communication skills exerted a buffering effect only for patients with lower levels of disease understanding.
CONCLUSIONS: Our findings indicate that improving physicians\' communication skills may be especially beneficial for reducing the maladaptive emotional reactions to symptom burden for patients with limited disease understanding. When time and resources for communication are restricted, enhanced awareness and focused training may be directed at communicating with patients who possess limited knowledge about their disease.