Communicating the diagnosis of multiple sclerosis - a qualitative study

被引:71
作者
Solari, A.
Acquarone, N.
Pucci, E.
Martinelli, V.
Marrosu, M. G.
Trojano, M.
Borreani, C.
Uccelli, M. Messmer
机构
[1] Ist Nazl Neurol Carlo Besta, Neuroepidemiol Unit, I-20133 Milan, Italy
[2] Dept Org & Dev, Genoa, Italy
[3] Hosp Macerata, Dept Neurol, Macerata, Italy
[4] Ist Sci San Raffaele, Dept Neurosci, I-20132 Milan, Italy
[5] Univ Osped San Raffaele, Milan, Italy
[6] Univ Cagliari, Dept Neurosci, Cagliari, Italy
[7] Univ Bari, Dept Neurol, Bari, Italy
[8] Univ Bari, Dept Psychiat Sci, Bari, Italy
[9] Ist Nazl Cura Tumori, Unit Psychol, Milan, Italy
[10] Italian Multiple Sclerosis Soc, Dept Social & Hlth Res, Genoa, Italy
关键词
communication; diagnosis; focus group; multiple sclerosis; qualitative research; shared decision-making; SHARED DECISION-MAKING; INFORMATION; RISK; NEWS; TELL; CARE; BAD;
D O I
10.1177/1352458506074689
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Studies on communicating the diagnosis of multiple sclerosis (MS) are few, and all reveal communication and information deficits. We explored the personal experience of diagnosis communication of people with MS and health professionals, using a qualitative methodology. Data were obtained from two sets of focus group meetings (FGM) with people with MS (total 23; 16 females; age range: 23-70) and one FGMs with health professionals (four neurologists, three psychologists, two nurses). The methods of framework analysis were applied to meeting transcripts to identify key topics and categories. The experience of communicating/receiving an MS diagnosis was highly varied; all patients reported the moment as powerfully evocative and unforgettable. Very poor levels of support and information were sometimes given. Although diagnosis communication had improved in more recent experience, all felt it should be further improved with appropriate setting (privacy, no interruptions, sufficient time), information tailored to the individual, and continuity of care. Such improvements imply a more meaningful patient-neurologist relationship, and also structural and organisational changes.
引用
收藏
页码:763 / 769
页数:7
相关论文
共 28 条
[1]   Communicating bad news [J].
Back, AL ;
Curtis, JR .
WESTERN JOURNAL OF MEDICINE, 2002, 176 (03) :177-180
[2]  
Bloor Michael., 1997, CONTEXT METHOD QUALI, P37, DOI [10.4135/9781849208758.n3, DOI 10.4135/9781849208758.N3]
[3]   What to tell patients with their first attack of multiple sclerosis - Concluding comments [J].
Caplan, LR .
EUROPEAN NEUROLOGY, 1996, 36 (04) :189-190
[4]   Shared decision-making in the medical encounter: What does it mean? (Or it takes at least two to tango) [J].
Charles, C ;
Gafni, A ;
Whelan, T .
SOCIAL SCIENCE & MEDICINE, 1997, 44 (05) :681-692
[5]   Effect of early interferon treatment on conversion to definite multiple sclerosis:: a randomised study [J].
Comi, G ;
Filippi, M ;
Barkhof, F ;
Durelli, L ;
Edan, G ;
Fernández, O ;
Hartung, HP ;
Seeldrayers, P ;
Sorensen, PS ;
Rovaris, M ;
Martinelli, V ;
Hommes, OR .
LANCET, 2001, 357 (9268) :1576-1582
[6]   TO TELL OR NOT TO TELL THE DIAGNOSIS OF MULTIPLE-SCLEROSIS [J].
ELIAN, M ;
DEAN, G .
LANCET, 1985, 2 (8445) :27-28
[7]   Developing a quality criteria framework for patient decision aids: online international Delphi consensus process [J].
Elwyn, Glyn ;
O'Connor, Annette ;
Stacey, Dawn ;
Volk, Robert ;
Edwards, Adrian ;
Coulter, Angela ;
Thomson, Richard ;
Barrat, Alexandra ;
Butow, Phyllis ;
Barry, Michael ;
Mulley, Albert G. ;
Sepucha, Karen ;
Bernstein, Steven ;
Clarke, Aileen ;
Entwistle, Vikki ;
Feldman-Stewart, Deb ;
Holmes-Rovner, Margaret ;
Llewellyn-Thomas, Hilary ;
Moumjid, Nora ;
Ruland, Cornelia ;
Sykes, Alan ;
Whelan, Tim .
BMJ-BRITISH MEDICAL JOURNAL, 2006, 333 (7565) :417-419
[8]   Communicating evidence for participatory decision making [J].
Epstein, RM ;
Alper, BS ;
Quill, TE .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (19) :2359-2366
[9]   Communicating sad, bad, and difficult news in medicine [J].
Fallowfield, L ;
Jenkins, V .
LANCET, 2004, 363 (9405) :312-319
[10]   Community services in multiple sclerosis: still a matter of chance [J].
Freeman, JA ;
Thompson, AJ .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2000, 69 (06) :728-732