Partizipative Entscheidungsfindung als Maßnahme zur Verbesserung der Arzt-Patient-Interaktion mit Fibromyalgie-Patientinnen

Article type: Research Article

Authors: Bieber, Christiane | Müller, Knut Georg | Blumenstiel, Klaus | Eich, Wolfgang

Affiliations: Klinik für Psychosomatische und Allgemeine Klinische Medizin, Medizinische Klinik, Universitätsklinikum Heidelberg. Im Neuenheimer Feld 410, 69120 Heidelberg. Tel.: 06221/56 38657; Fax: 06221/56 5988, E-mail: [email protected]

Abstract: Objectives: In the treatment of fibromyalgia syndrome (FMS) patients and their physicians frequently complain of having difficulties interacting with each other. We investigated the extent of physician-patient interactions classified as difficult and whether a treatment in accordance with Shared Decision Making (SDM) principles was apt to improve physician-patient interaction. Methods: The 62 FMS-patients who participated in the randomized controlled trial were allocated to either an SDM group or an information group. Both groups had access to a com-puter based information program on FMS, but only the SDM group was treated by physicians who had received a special SDM communication training. Physician-patient interaction was assessed in both patients and physicians through standardized questionnaires directly after the first consultation and after a second consultation three months later. Results: The proportion of interactions with FMS-patients classified as difficult by their physicians was high at the time of follow-up: 29% within the SDM group and 61% within the information group. Both FMS-patients and physicians of the SDM group reported less interaction difficulties when compared with the information group. For physicians in the SDM group, difficult interactions decreased even more at the follow-up. Conclusion: Treatment in accordance with SDM principles is able to reduce difficulties in physician-patient interaction from the point of view of both partners involved.

Keywords: Fibromyalgia syndrome (FMS), Shared Decision Making (SDM), physician-patient inter-action, Difficult Doctor Patient Relationship Questionnaire (DDPRQ), chronic pain

Journal: Zeitschrift für Medizinische Psychologie, vol. 15, no. 2, pp. 53-60, 2006