诊断的不确定性在病人,家长和医生:代偿控制理论的观点。

IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Health Psychology Review Pub Date : 2023-09-01 DOI:10.1080/17437199.2022.2086899
Ashley McKoane, David K Sherman
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引用次数: 3

摘要

医学诊断提供了一种结构,通过这种结构可以减轻心理上的不确定性,使患者减少心理威胁,并将重点放在健康预后上。然而,当无法做出诊断时,患者可能会经历诊断的不确定性——认为医学领域无法对其健康问题的原因提供准确的解释。本综述探讨了诊断不确定性对个体控制和理解需求的心理威胁,以及患者、儿科患者家长和医生所经历的后果。以补偿控制理论为框架,我们提出了一种行为分类,人们在面对诊断不确定性时可能采取的行为分类,以重新获得控制,并重申世界不是随机和混乱的。为了管理诊断的不确定性,人们可能会加强他们的个人能动性,与他们认为符合他们利益的外部系统联系在一起,肯定行为和结果之间的明确联系,并肯定非特定的认知结构。诊断的不确定性是从患者、儿科患者的父母和医生的角度来探讨的,展示了每一组如何反应,以保持世界有结构而不是随机的感觉。讨论集中在调节,限制和临床实践的影响。
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Diagnostic uncertainty in patients, parents, and physicians: a compensatory control theory perspective.

Medical diagnoses offer a structure by which psychological uncertainty can be attenuated, allowing patients to diminish psychological threats and focus on health prognosis. Yet when no diagnosis can be made, patients may experience diagnostic uncertainty - perceiving the medical field as unable to provide an accurate explanation of the cause of their health problems. This review examines the psychological threat that diagnostic uncertainty imposes on individuals' need for control and understanding, and the resulting consequences experienced by patients, parents of pediatric patients, and physicians. Using compensatory control theory as a framework, we propose a taxonomy of behaviors that people may adopt in order to regain control in the face of diagnostic uncertainty and to reaffirm that the world is not random and chaotic. To manage diagnostic uncertainty, people may bolster their personal agency, affiliate with external systems they see as acting in their interest, affirm clear connections between behaviors and outcomes, and affirm nonspecific epistemic structure. Diagnostic uncertainty is approached from the perspectives of patients, parents of pediatric patients, and physicians, demonstrating how each group responds in order to maintain a sense that the world has structure and is not random. Discussion centers on moderators, limitations, and implications for clinical practice.

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来源期刊
Health Psychology Review
Health Psychology Review PSYCHOLOGY, CLINICAL-
CiteScore
21.30
自引率
0.00%
发文量
28
期刊介绍: The publication of Health Psychology Review (HPR) marks a significant milestone in the field of health psychology, as it is the first review journal dedicated to this important and rapidly growing discipline. Edited by a highly respected team, HPR provides a critical platform for the review, development of theories, and conceptual advancements in health psychology. This prestigious international forum not only contributes to the progress of health psychology but also fosters its connection with the broader field of psychology and other related academic and professional domains. With its vital insights, HPR is a must-read for those involved in the study, teaching, and practice of health psychology, behavioral medicine, and related areas.
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