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首页> 外文期刊>BMC Family Practice >“Doctor, please tell me it’s nothing serious”: an exploration of patients’ worrying and reassuring cognitions using stimulated recall interviews
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“Doctor, please tell me it’s nothing serious”: an exploration of patients’ worrying and reassuring cognitions using stimulated recall interviews

机译：“医生，请告诉我这没什么大不了的”：使用刺激性回忆访谈探讨患者的担忧和令人放心的认知

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Background Many patients who consult their GP are worried about their health, but there is little empirical data on strategies for effective reassurance. To gain a better understanding of mechanisms for effective patient reassurance, we explored cognitions underlying patients’ worries, cognitions underlying reassurance and factors supporting patients’ reassuring cognitions. Methods In a qualitative study, we conducted stimulated recall interviews with 21 patients of 12 different GPs shortly after their consultation. We selected consultations in which the GPs aimed to reassure worried patients and used their videotaped consultation as a stimulus for the interview. The interviews were analysed with thematic coding and by writing interpretive summaries. Results Patients expressed four different core cognitions underlying their concerns: ‘I have a serious illness’, ‘my health problem will have adverse physical effects’, ‘my treatment will have adverse effects’ and ‘my health problem will negatively impact my life’. Patients mentioned a range of person-specific and context-specific cognitions as reasons for these core cognitions. Patients described five core reassuring cognitions: ‘I trust my doctor’s expertise’, ‘I have a trusting and supporting relationship with my doctor’, ‘I do not have a serious disease’, ‘my health problem is harmless’ and ‘my health problem will disappear.’ Factors expressed as reasons for these reassuring cognitions were GPs’ actions during the consultation as well as patients’ pre-existing cognitions about their GP, the doctor-patient relationship and previous events. Patients’ worrying cognitions were counterbalanced by specific reassuring cognitions, i.e. worrying and reassuring cognitions seemed to be interrelated. Conclusions Patients described a wide range of worrying cognitions, some of which were not expressed during the consultation. Gaining a thorough understanding of the specific cognitions and tailoring reassuring strategies to them should be an effective way of achieving reassurance. The identified reassuring cognitions can guide doctors in applying these strategies in their daily practice.
机译：背景许多咨询全科医生的患者都担心自己的健康，但是关于有效保证策略的经验数据很少。为了更好地了解有效的患者放心机制，我们探讨了患者担忧的基础认知，放心基础的认知以及支持患者放心认知的因素。方法在一项定性研究中，我们在咨询后不久对来自12个不同GP的21例患者进行了激发回忆访谈。我们选择了全科医生旨在使患者放心的咨询，并利用他们的录像咨询作为访谈的刺激。通过专题编码和撰写解释性摘要对访谈进行了分析。结果患者对他们所关注的问题表达了四种不同的核心认知：“我有严重的疾病”，“我的健康问题将对身体造成不利影响”，“我的治疗将产生不利影响”以及“我的健康问题将对我的生活产生负面影响”。患者提到了一系列特定于个人和特定于上下文的认知作为这些核心认知的原因。患者描述了五项令人放心的核心认知：“我相信我的医生的专业知识”，“我与我的医生有信任和支持的关系”，“我没有严重的疾病”，“我的健康问题无害”和“我的健康问题”这些令人放心的认知的原因表示为全科医生在会诊期间的行为以及患者对全科医生，医患关系和先前事件的先前认知。特定的令人放心的认知可以抵消患者的令人担忧的认知，也就是说，令人担忧的认知和令人放心的认知似乎是相互关联的。结论患者描述了多种令人担忧的认知，其中一些在咨询期间未表达。全面了解特定的认知并为其量身定制放心的策略应该是一种获得放心的有效方法。确定的令人放心的认知可以指导医生在日常实践中应用这些策略。

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