家长医患沟通效能对孤独症谱系障碍儿童康复效果的影响
Impact of parental efficacy in doctor-patient communication on rehabilitation outcomes for children with autism spectrum disorder
卫宁 1曾艳玲 1蒋娜 1张倩 1益筱哲 1王建云 2王登廷 2张艳 2裴泓波 1黄朝荣2
作者信息
- 1. 兰州大学公共卫生学院,甘肃兰州市 730000
- 2. 甘肃省康复中心医院,甘肃兰州市 730000
- 折叠
摘要
目的 从家长医患沟通效能的视角,探究针对孤独症谱系障碍(ASD)儿童康复效果的潜在影响因素及其复杂作用路径,为提升ASD儿童的康复服务质量提供依据.方法 采用面对面匿名问卷调查的方式,收集甘肃省儿童康复定点机构ASD儿童家长的一般信息、家长医患沟通效能、家长治疗依从性、儿童康复效果等相关资料,应用结构方程模型探索家长医患沟通效能对ASD儿童康复效果的影响机制.结果 共收集甘肃省13个市/州37家儿童康复机构的ASD儿童家长519名,家长医患沟通效能、医患关系、家长治疗依从性和ASD儿童康复效果两两之间均呈正相关(P＜0.05);结构方程模型分析结果为:家长医患沟通效能对ASD儿童康复效果的标准化直接效应值为0.151(P=0.023),医患关系、家长治疗依从性的中介效应值分别为0.160(P=0.001)、0.111(P=0.001),医患关系和家长治疗依从性的链式中介效应值为0.035(P=0.001),"家长医患沟通效能→医患关系→ASD儿童康复效果"占总中介效应的比例最高,为52.29%.结论 家长医患沟通效能可直接及间接通过医患关系和家长治疗依从性对ASD儿童康复效果发挥积极作用.康复机构应注重家长医患沟通效能的培养,加强高质量及人性化的康复服务.
Abstract
Objective To explore the potential influencing factors and complex pathways affecting rehabilitation effect for children with autism spectrum disorder(ASD)from the perspective of parental efficacy in doctor-patient communication,and to provide evidence for improving the quality of rehabilitation service for children with ASD.Methods An anonymous face-to-face questionnaire survey was conducted to collect general demographic information of parents of children with ASD at designated rehabilitation institutions in Gansu province.The data included paren-tal efficacy in doctor-patient communication,parental compliance of treatment and children's rehabilitation out-comes were collected.A structural equation model was used to explore the impact mechanism of parental commu-nication efficacy on the rehabilitation outcomes of children with ASD.Results Data from 519 parents at 37 rehabilitation institutions across 13 cities/counties in Gansu province were collect-ed.Significant positive correlations were found between parental efficacy in doctor-patient communication,doc-tor-patient relationships,parental compliance with treatment and rehabilitation outcomes for children with ASD(P＜0.05).Through structural equation model analysis,the standardized direct effect of children with ASD from parents'doctor-patient communication efficacy was 0.151(P=0.023).The mediating effect of doctor-patient rela-tionship and parental compliance with treatment were 0.160(P=0.001)and 0.111(P=0.001),respectively,with a chained mediating effect of 0.035(P=0.001).The pathway"parental efficacy in doctor-patient communica-tion → doctor-patient relationship → ASD child's rehabilitation outcome"accounted for the highest proportion of the total mediating effect,at 52.29%.Conclusion Parental doctor-patient communication efficacy may positively impact on the rehabilitation outcomes of chil-dren with ASD directly,and indirectly through the doctor-patient relationship and parental compliance with treat-ment.Rehabilitation institutions should focus on fostering parental communication skills and enhancing high-quality and humanized rehabilitation services.
关键词
孤独症谱系障碍/儿童/医患沟通效能/康复效果/结构方程模型Key words
autism spectrum disorder/children/doctor-patient communication efficacy/rehabilitation outcome/structural equation model引用本文复制引用
基金项目
甘肃省卫生健康行业科研项目(GSWSKY2022-04)
出版年
2024
国家科技期刊平台
NSTL
万方数据