预测患者对心理结局及治疗后皮肤外观满意度的因素

Charalambos Costeris, M. Petridou, Y. Ioannou
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摘要

目的:探讨皮肤科患者的人口学特征和社会特征是否能预测其对医疗结果的满意度。此外,它侧重于两个方面的患者满意度;首先,心理因素可以预测医疗结果的满意度,其次,治疗后皮肤外观的满意度。方法:108例患者(18~35岁)参与研究。54人被皮肤科医生诊断为严重可见面部囊性痤疮(A组),54人被诊断为不可见的牛皮癣/湿疹(B组)。研究包括两个评估阶段:皮肤科治疗前和治疗后阶段。在治疗前,所有患者同意皮肤科医生开始治疗,并进行社会人口调查问卷、成人BDD诊断模块、多维身体-自我关系问卷、人际支持评价表和罗森博格自尊量表。在皮肤科治疗后阶段(患者完成皮肤科治疗6个月后),对所有参与者进行随访评估,并对患者的医疗结果满意度进行问卷调查。结果:患者以前的地址,专家为他们的皮肤疾病预测较低的满意度的医疗结果。患者在皮肤科治疗前较低的整体外观满意度和患者所属的群体(可见或不可见的皮肤疾病),预测对医疗结果的满意度较高。患者出现明显皮肤疾病(痤疮组)的可能性越高,且患者对其在皮肤科治疗前的整体外观越不满意,则患者对治疗后皮肤外观的满意度越高。最后,如果患者符合BDD的诊断标准,并且他们在皮肤科治疗前的社会支持感知越高,他们对治疗后皮肤外观的满意度就越低。结论:皮肤科患者对医疗效果的满意度和对皮肤外观的满意度是两个不同的感知领域。两者均可由多种心理因素预测,因此在皮肤科治疗前对患者进行心理评估是必要的。
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Factors that Predict Patients' Satisfaction with the Psychological Outcome and the Appearance of their Skin after Treatment
Objective: The present study examined whether dermatological patients’ demographic and social characteristics could predict their satisfaction with the medical outcome. Moreover, it focused on two aspects of patients’ satisfaction; firstly, psychological factors that could predict satisfaction from the medical outcome and secondly, satisfaction from the appearance of their skin, after treatment. Methods: 108 patients (18~35 years) participated in the study. Fifty four were diagnosed by their Dermatologists with severe visible facial cystic acne (Group A) and 54 with non-visible psoriasis/eczema (Group B). The study included two assessment phases: prior to and post dermatological treatment phase. At prior to treatment phase, all patients agreed with their Dermatologist to begin medical treatment and were administered the Sociodemographic questionnaire, the BDD Diagnostic Module-for adults, the Multidimensional body–self relations questionnaire, the Interpersonal support evaluation list and the Rosenberg self-esteem scale. At post dermatological treatment phase (six months after patients completed their dermatological treatment), there was a follow-up assessment and all participants were administered the Questionnaire on patients' satisfaction with the medical outcome. Results: Patients’ previous address to a specialist for their skin disorder predicts lower levels of satisfaction with the medical outcome. Patients' lower overall appearance satisfaction at prior to dermatological treatment phase and the group in which patients belong (visible or non-visible skin disorder), predict higher satisfaction with the medical outcome. The higher the possibility that a patient has a visible skin disorder (group of acne) and the less satisfied they are with their overall appearance at prior to dermatological treatment phase, the higher their satisfaction with the appearance of their skin after treatment is predicted to be. Lastly, if a patient fulfills the criteria for the diagnosis of BDD and the higher their perceived social support at prior to dermatological treatment phase, the lower their satisfaction with the appearance of their skin after treatment is predicted to be. Conclusion: Satisfaction with the medical outcome and satisfaction with the appearance of the skin are two perceptually different areas for dermatological patients. They are both found to be predicted by various psychological factors and as such psychological assessment of patients prior to dermatological treatment is deemed necessary.
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