Medical Metaphors That May Reinforce Misconceptions Are Associated With Increased Trust in the Clinician.

IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES Quality Management in Health Care Pub Date : 2024-03-26 DOI:10.1097/QMH.0000000000000447
Calvin Chandler, Ali Azarpey, Niels Brinkman, David Ring, Lee Reichel, Sina Ramtin
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Abstract

Background and objectives: This study measured patient reactions to medical metaphors used in musculoskeletal specialty offices and asked: (1) Are there any factors associated with patient thoughts and emotions in response to common metaphors? (2) Is there a difference between patient ratings of metaphors rated as potentially reinforcing misconceptions and those that are more neutral?

Methods: In a cross-sectional study, 228 patients presenting to multiple musculoskeletal specialty offices rated reactions to 4 metaphors presented randomly from a set of 14. Two were categorized as potentially reinforcing common misconceptions and 2 as relatively neutral. Bivariate tests and multivariable regression identified factors associated with patient ratings of levels of emotion (using the standard assessment manikins) and aspects of experience (communication effectiveness, trust, and feeling comfortable rated on 11-point ordinal scales) in response to each metaphor.

Results: Levels of patient unhelpful thinking or distress regarding symptoms were not associated with patient ratings of patient emotion and experience in response to metaphors. Metaphors that reinforce misconceptions were associated with higher ratings of communication effectiveness, trust, and comfort (P < .05).

Conclusion: The observation that metaphors that validate a person's understanding of his or her illness may elicit trust even if those metaphors have the potential to reinforce misconceptions may account for the common usage of such metaphors. Clinicians can work to incorporate methods for building trust without reinforcing misconceptions.

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可能强化误解的医学隐喻与增加对临床医生的信任有关。
背景和目的:本研究测量了患者对肌肉骨骼专科诊室中使用的医学隐喻的反应,并提出以下问题:(1)患者对常见隐喻的想法和情绪与哪些因素有关?(2)患者对那些可能强化错误观念的隐喻和那些较为中性的隐喻的评价是否存在差异?在一项横断面研究中,228 名到多家肌肉骨骼专科诊所就诊的患者对从一组 14 个隐喻中随机呈现的 4 个隐喻的反应进行了评分。其中两个可能会强化常见的错误观念,另外两个则相对中性。双变量测试和多变量回归确定了与患者对每种隐喻的情绪水平(使用标准评估人体模型)和体验方面(以 11 点序数量表评定沟通效果、信任度和舒适感)评分相关的因素:结果:病人对症状的无益思维或痛苦程度与病人对隐喻的情绪和体验评分无关。强化误解的隐喻与较高的沟通有效性、信任度和舒适度评分相关(P < .05):即使这些隐喻有可能强化误解,但验证患者对其疾病的理解的隐喻可能会引起患者的信任,这可能是此类隐喻被广泛使用的原因。临床医生可以在不强化误解的情况下,努力采用建立信任的方法。
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来源期刊
Quality Management in Health Care
Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
1.90
自引率
8.30%
发文量
108
期刊介绍: Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.
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