Kommunikationspräferenzen onkologischer Patienten

Zusammenfassung

Ziel:

Nach der Prüfung der psychometrischen Eigenschaften eines Fragebogens zur Erfassung der Präferenzen von Patienten bezüglich der Pa­tient-Behandler-Kommunikation (KOPRA-Fragebogen) erfolgt eine Beschreibung der Kommunikationspräferenzen onkologischer Patienten. Dazu wird nach soziodemografischen Untergruppen unterschieden und ein Vergleich mit den Präferenzen von Patienten mit Rückenschmerzen und chronisch-ischämischer Herzkrankheit durchgeführt.

Methode:

Es wurden N=1 635 Patienten aus 31 onkologischen Praxen befragt. Beim KOPRA-Fragebogen wurden Reliabilität, Eindimensionalität und die Passung zum Rasch-Modelle geprüft. Um Subgruppenanalysen und Vergleiche mit anderen Diagnosen durchzuführen, wurden hierarchische Modelle angewandt.

Ergebnisse:

Die psychometrischen Eigenschaften des KOPRA fallen insgesamt befriedigend bis gut aus. Den Patienten sind die 4 mit dem KOPRA erfassten Kommunikationsbereiche (Patientenbeteiligung und Patientenorientierung, effektive und offene Kommunikation, emotional unterstützende Kommunikation, Kommunikation über persönliche Verhältnisse) ähnlich wichtig. Frauen haben generell höhere Erwartungen an das kommunikative Verhalten des Arztes. Affektive Kommunikation ist Krebs-Patienten wesentlich wichtiger als Rückenschmerzpatienten oder kardiologischen Patienten.

Schlussfolgerung:

Der KOPRA-Fragebogen ist für die Untersuchung von Kommunikationspräferenzen onkologischer Patienten gut geeignet. In der Regel ist ein Arztverhalten optimal, welches auf allen 4 KOPRA-Dimensionen hohe Werte aufweist. Insbesondere in Fällen, wo die 4 Kommunikationsanforderungen in Konflikt zueinander treten, sollte eine Individualisierung des ärztlichen Kommunikationsstils erfolgen.

Abstract

Purpose:

After testing the psychometric properties of a new questionnaire that measures patient preferences for patient-physician communication (KOPRA questionnaire), the communication preferences of cancer patients were described. In order to do this, the preferences were differentiated according to sociodemographic subgroups and a comparison was made to the preferences of patients with chronic back pain and chronic ischaemic heart disease.

Methods:

N=1 635 patients from 31 medical oncology practices were surveyed. For the KOPRA questionnaire, reliability, unidimensionality, and fit to the Rasch model were tested. Hierarchical models were used to conduct subgroup analyses and comparisons with other diseases.

Results:

The psychometric properties of the KOPRA are satisfactory to good. For patients, the 4 communication domains (patient participation and patient orientation, effective and open communication, emotionally supportive communication, communication about personal circumstances) measured by the KOPRA questionnaire are equally important. Women generally have higher expectations of the physician’s communicative behaviour. Affective communication is considerably more important for cancer patients than for back pain or cardiac patients.

Conclusion:

The KOPRA questionnaire is well suited for examining the communication preferences of cancer patients. In general, physician behaviour associated with high scores in all 4 KOPRA dimensions is optimal. Especially in cases where the 4 communication aspects conflict with each other, the physician’s communication style should be individualised.

Schlüsselwörter

Patient-Behandler-­Beziehung - Patient-Behandler-­Kommunikation - Kommunikationspräferenzen - Patientenorientierung - Onkologie

Key words

patient-physician relationship - patient-physician communication - communication preferences - patient participation - oncology

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