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“请帮我看看我正在斩杀的龙”:一种新型医患咨询方案的实施及患者体验调查。

"Please Help Me See the Dragon I Am Slaying": Implementation of a Novel Patient-Pathologist Consultation Program and Survey of Patient Experience.

机构信息

From the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Booth); the Departments of Pathology and Laboratory Medicine (Dr Joseph) and Radiation Medicine (Dr Katz), Lowell General Hospital, Lowell, Massachusetts; the Department of Pathology, Newton-Wellesley Hospital, Newton, Massachusetts (Dr Misialek); and the Department of Pathology, University of Mississippi Medical School, University of Mississippi Medical Center, Jackson (Dr Allen).

出版信息

Arch Pathol Lab Med. 2019 Jul;143(7):852-858. doi: 10.5858/arpa.2018-0379-OA. Epub 2018 Nov 6.

Abstract

CONTEXT.—: Pathologists evaluate human disease and teach medical students, residents, and clinicians. Historically recognized as the "doctor's doctor," pathologists are well suited to be a direct patient resource of individualized, accurate information.

OBJECTIVE.—: To develop and implement a pathology consultation service whereby patients review their tissue slides directly with pathologists.

DESIGN.—: A pathologist conducted patient consultations, reviewing biopsy or surgery findings on a multiheaded microscope or computer screen. The pathologist evaluated patients' understanding of their disease and invited patients to ask specific questions. We recorded patient demographic data and assessed utilization with a short patient satisfaction survey using 6 questions with a 5-point Likert scale and 2 questions for open response.

RESULTS.—: A total of 31 patients came for consultation; 39% (12 of 31) were accompanied by a friend or family member. Patients' median age was 59 years, with a strong female predominance (90%; 28 of 31). The majority of patients had breast cancer (58%; 18 of 31) or hematologic malignancy (19%; 6 of 31). Of the 31 patients, the survey response rate was 58% (18 of 31). Top-box scoring demonstrated program support, with 89% (16 of 18) of respondents strongly recommending the experience to another patient. Additionally, 78% (14 of 18) strongly agreed that they felt more empowered after seeing their disease. Mean scores for Likert-based questions all were higher than 4.0.

CONCLUSIONS.—: To our knowledge, this study is the first report of direct patient-pathologist consultation. Early data suggest that the program may provide effective patient-specific education. The high response rate and favorable assessment of the program suggest that it may be a valuable resource for some patients.

摘要

背景

病理学家评估人类疾病并为医学生、住院医师和临床医生授课。病理学家历来被认为是“医生的医生”,非常适合成为患者获取个性化、准确信息的直接资源。

目的

开发并实施病理咨询服务,使患者能够直接与病理学家一起查看组织切片。

设计

病理学家通过多头显微镜或电脑屏幕对活检或手术结果进行患者咨询。病理学家评估患者对自身疾病的理解程度,并邀请患者提出具体问题。我们记录了患者的人口统计学数据,并通过一个包含 6 个 5 分制问题和 2 个开放式问题的简短患者满意度调查来评估利用情况。

结果

共有 31 名患者前来咨询;39%(31 人中的 12 人)由朋友或家人陪同。患者的中位年龄为 59 岁,女性居多(90%,31 人中的 28 人)。大多数患者患有乳腺癌(58%,31 人中的 18 人)或血液系统恶性肿瘤(19%,31 人中的 6 人)。在 31 名患者中,调查回复率为 58%(31 人中的 18 人)。在回答问题时,最高得分为 5 分,有 89%(18 人中有 16 人)的受访者强烈推荐其他患者体验该服务。此外,78%(18 人中有 14 人)强烈同意他们在了解自己的疾病后感到更有力量。基于 Likert 量表的问题平均得分均高于 4.0。

结论

据我们所知,这项研究是首次报告直接的医患咨询。早期数据表明,该项目可能为患者提供有效的个性化教育。高回复率和对项目的好评表明,该项目可能对一些患者有价值。

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