医疗服务提供者的支持性沟通能否增强轻度和重度功能障碍情境下的信任与治疗依从态度？一项基于网络的实验研究。

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中文摘要

目的： 医疗提供者与患者的沟通方式会影响患者对提供者的信任及其对治疗依从的态度。本研究探讨了提供者沟通的这种影响是否受到功能障碍严重程度和参与者性别的调节。
参与者与方法： 在一项在线实验中，参与者（N = 508）被要求想象自己患有轻度或重度嗅觉功能障碍（OD）。随后，他们被随机分配观看一段视频，视频中医疗提供者提供嗅觉训练（OT）作为OD的治疗，并采用中性或情感支持性沟通。之后，参与者对提供者的信任感、对治疗有效性的态度、治疗参与度、治疗不愉快感和治疗风险进行评分。在观看视频前后测量状态焦虑。
结果： 支持性沟通比中性沟通引发了更高的对提供者的信任，效应量为小到中等（Cohen's d = 0.36）。虽然支持性沟通没有直接影响焦虑，但探索性分析显示，在支持性沟通组中，更高的信任水平与更低的焦虑相关。此外，支持性沟通引发了更高的治疗有效性态度。沟通未影响其他治疗依从态度。功能障碍严重程度未影响对提供者的信任和治疗依从态度。男性报告的治疗不愉快感低于女性，未出现其他性别差异。
结论： 支持性沟通可能引发更高的对提供者的信任，且不受功能障碍严重程度和性别的影响，然而其效应可能比先前假设的更小，并且对治疗依从态度没有影响。治疗依从态度感知的性别差异似乎有限。

英文摘要

PURPOSE: The way healthcare providers communicate with patients can influence patients' trust in providers and their attitudes toward treatment adherence. The present study investigated whether such influences of providers' communication can be modulated by dysfunction severity and participant gender.
PARTICIPANTS AND METHODS: In an online experiment, participants (N = 508) were instructed to imagine having either mild or severe olfactory dysfunction (OD). They were then randomized to watch a video of a healthcare provider delivering an olfactory training (OT) as a treatment for OD, with either neutral or emotionally supportive communication. Participants then rated their perceived trust in the provider, attitudes toward treatment effectiveness, treatment engagement, treatment unpleasantness, and treatment risk. State anxiety was measured before and after watching the videos.
RESULTS: Supportive communication elicited higher trust in the provider than neutral communication, with a small to medium effect size (Cohen's d = 0.36). While supportive communication did not directly affect anxiety, exploratory analyses showed that higher levels of trust in the supportive communication group were linked to lower anxiety. Moreover, supportive communication elicited higher treatment effectiveness attitude. No other treatment adherence attitudes were affected by the communication. Dysfunction severity did not affect trust in provider and treatment adherence attitudes. Men reported lower perceived treatment unpleasantness than did women, and no other gender differences emerged.
CONCLUSION: Supportive communication may elicit higher trust in provider independent of dysfunction severity and gender, however, likely with a smaller effect than previously assumed, and with no influence on attitudes toward adherence to treatment. Gender differences in perceived attitudes toward treatment adherence appear to be limited.