Surgeon confidence in an outpatient setting
Tóm tắt
We have the impression that provider uncertainty arises from either nonspecific pathology or disproportionate symptoms and disability, both of which correlate with symptoms of depression, heightened illness concern, and low patient self-efficacy. This study tested the primary null hypothesis that there is no correlation between provider confidence and patient self-efficacy. Eighty-five patients visiting an orthopedic hand and upper extremity surgeon completed the Pain Self-Efficacy Questionnaire (PSEQ). The surgeon’s confidence in the diagnosis, optimal treatment, expected outcome, and the anticipated satisfaction of the patient and the referring doctor were measured with five questions rated on 5-point Likert scales (Physician Confidence Scale). Overall physician confidence was high and there was no correlation between the PSEQ score and the Physician Confidence Scale. Provider confidence was significantly lower for nonspecific diagnoses, but there was no significant difference between the mean PSEQ for the 72 patients with a specific diagnosis and the 12 patients with nonspecific diagnoses. Physician confidence did not relate with self-efficacy in this study. Level of Evidence: Prognostic, level II
Tài liệu tham khảo
Arnstein P, Caudill M, Mandle CL, et al. Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain. 1998;80:483–91.
Bates DW, Gawande AA. Error in medicine: what have we learned? Minn Med. 2000;83(7):18–23.
Burroughs TE, Waterman AD, Gallagher TH, Fraser VJ, et al. Patient concerns about medical errors in emergency departments. Acad Emerg Med. 2005;12(1):57–64.
Friedman C, Gatti G, Elstein A, et al. Are clinicians correct when they believe they are correct? Implications for medical decision support. Stud Health Technol Inform. 2001;84(Pt 1):454–8.
Friedman CP, Gatti GG, Franz TM, et al. Do physicians know when their diagnoses are correct? Implications for decision support and error reduction. J Gen Intern Med. 2005;20(4):334–9.
Kohn LTCJ, Donaldson MS, editors. To err is human: building a safer health system. Washington, DC: National Academy; 2000.
Leape LL, Bates DW, Cullen DJ, et al. Systems analysis of adverse drug events. ADE Prevention Study Group. JAMA. 1995;274(1):35–43.
Newman-Toker DE, Pronovost PJ. Diagnostic errors—the next frontier for patient safety. JAMA. 2009;301(10):1060–2.
Nicholas MK. The pain self-efficacy questionnaire: taking pain into account. Eur J Pain. 2007;11(2):153–63.
Nicholas MK. Self-efficacy and chronic pain. Paper presented at the annual conference of the British Psychological Society, St. Andrews, Scotland. 1989.
Rahman A, Ambler G, Underwood MR, et al. Important determinants of self-efficacy in patients with chronic musculoskeletal pain. J Rheumatol. 2004;31(6):1187–92.
Survey Y. Misdiagnosis leads to breakdown in doctor-patient relationship. Isabelhealthcare.com. 2006. Accessed 28 Aug 2012.
Vranceanu AM, Safren S, Zhao M, Cowan J, Ring D. Disability and psychologic distress in patients with nonspecific and specific arm pain. Clin Orthop Relat Res. 2008;466(11):2820–6.