患者信任医生与焦虑、健康相关生命质量的关系

Relationships among the Patient Trust in Doctor,Anxiety and Quality of Life

目的探讨患者对医生的信任、焦虑状况和健康相关生命质量之间的关系,旨在研究医患关系及改善对患者健康的作用。方法通过对住院患者的调查,编制患者对医生的信任量表,并结合SF-36健康状况问卷和状态-特质焦虑问卷展开研究。结果①患者信任医生量表包括"患者中心"和"职业素养"2个维度,具有良好的信度和效度;②市级医院患者对医生的信任程度显著高于县级医院患者(t=3.62,P<0.001);③患者对医生的信任程度对其状态焦虑有预测作用(β=-0.248,P<0.01),对生命质量的活力(β=0.278,P<0.01)、社会功能(β=0.322,P<0.001)、情感职能(β=0.197,P<0.05)、精神健康(β=0.223,P<0.05)有预测作用;④焦虑在患者对医生的信任与生命质量之间有中介作用。当焦虑进入回归方程时,信任对活力的预测效应由0.278降至0.148、对社会功能的预测效应由0.322降至0.233、对情感职能的预测效应由0.197降至0.147、对精神健康的预测效应由0.223降至0.096。结论患者的信任可通过降低焦虑等途径间接影响患者治疗和康复。

Objective To explore the relationship of doctors and patients and improve the health of patients on the basis of trust between doctor and patient. Methods Using the scale of patient trust in doctor formed by interviewing patients in hospital,SF-36 health survey questionnaire and State Anxiety Inventory to investigate. Results ①The scale patient trust in doctor contained two dimensions ：Patient--in--center and professionalism,which showed acceptable reliability and validity;②The patients in the county hospital trusted doctors more than those in municipal hospital（t= 3.62 ,P〈0. 001） ;③The trust of patients for doctor could predict anxiety （β= -0. 248, P〈 0.01 ）, life vitality （β= 0. 278, P〈 0.01 ）, social functioning （β = 0. 322, P〈 0. 001 ）, role-emotional （β= 0. 197, P〈0. 05） ,mental health （β= 0. 223 ,P〈0.05）of health related quality of life;④The anxiety of patient mediated between the trust and some aspects of health related quality of life. Once anxiety entered the equation as a predictor,the effect of trust on life vitality dropped from 0. 278 to 0. 148,the effect of trust on social functioning dropped from 0. 322 to 0. 233,the effect of trust on role-emotional dropped from 0. 197 to 0. 147,the effect of trust on mental health dropped from 0. 223 to 0. 096. Conclusion The trust of patients can affect their therapy and healing indirectly by decreasing anxiety and other methods.