摘要
本文旨在探索叙事医学以平行病历的形式在慢性疼痛住院患者中应用的可行性及效果。采用历史性对照研究,40例慢性疼痛患者为对照组,40例慢性疼痛患者为叙事组。叙事组在常规诊疗基础上,进行叙事医学访谈,并书写平行病历。比较两组患者在医患关系量表-患者评(PDRQ-9)总分,诊疗关系共情量表(CARE)总分及患者出入院时心理痛苦温度计(DT)得分。结果示:叙事组PDRQ-9总分(40.63±2.40)显著高于对照组(38.70±3.33)(P=0.004);叙事组CARE总分(43.23±4.86)显著高于对照组(39.40±8.75)(P=0.018);DT得分入院时没有显著统计学差异,出院时叙事组DT(1.68±1.41)得分显著低于对照组(2.73±2.04)(P=0.011)。因此叙事医学的临床践行,可以提高患者对医患关系满意度,患者感受到医生体会自己的程度较高,并能降低心理痛苦程度。
This article aims to explore the feasibility and effectiveness of narrative medicine in the use of parallel medical records in hospitalized patients with chronic pain.Using the historical control study,40 patients with chronic pain were selected as the control group,40 patients were selected as the narrative group.Besides the routine diagnosis and treatment,narrative medical interviews were conducted and parallel medical records were written in patients in narrative group.The two groups of patients were compared in the total score of Patient-Doctor Relationship Questionnaire（PDRQ-9）,the total score of the Consultation and Relational Empathy Measure（CARE）,and Distress Thermometer（DT）score on admission and at discharge.The total score of PDRQ-9 in the narrative group（40.63±2.40）was significantly higher than that in the control group（38.70±3.33）（P=0.004）.The total score of CARE in the narrative group（43.23±4.86）was significantly higher than that of the control group（39.40±8.75）（P=0.018）;There was no significant statistical difference in the DT score at admission,and the DT（1.68±1.41）score in the narrative group at the time of discharge was significantly lower than that in the control group（2.73±2.04）（P=0.011）.The practice of narrative medicine in the form of parallel medical records can improve patient satisfaction with doctor-patient relationship.Patients feel that doctors understand themselves to a higher degree and can reduce psychological distress.
作者
付世欧
李文燕
FU Shi-ou;LI Wen-yah(Department of Pain Treatment , Qingdao Municipal Hospital, Qingdao Pain Clinical Research and Treatment Center, Qingdao 266011, China)
出处
《医学与哲学（B）》
2018年第5期76-78,共3页
Medicine & Philosophy(B)
关键词
慢性疼痛
叙事医学
医患关系
共情
心理痛苦
chronic pain, narrative medicine, doctor patient relationship, empathy, psychological pain
