d'Elia G
Universitetet i Bergen, Psykiatrisk Institutt, Haukeland Sykehus, Bergen, Norge.
Lakartidningen. 1999 Jan 20;96(3):203-6.
Communication is a central feature of patient-doctor interaction, and one that is often problematic. Listening is so basic that we tend to take it for granted. Unfortunately, most of us think ourselves better listeners than we really are. Especially distressing are deaf ears among those we count on for understanding. Doctors are powerful social figures, expected to manifest appropriate skills in encountering anxious, unhappy, disappointed, angry or even hypochondriac patients. The article consists in a review of an interview method based on cognitive principles, specially designed to promote the patient's feeling of being listened to, and to establish a working relationship. Such skills as non-verbal communication, reflection, summation, and self-disclosure are essential components of the method. The patient's emotional response to health problems is viewed as being valid, and investigation is initiated on the basis of the patient's perception of the problem rather than on the doctor's professional knowledge. Through Socratic questioning, the doctor helps patients to reach their own conclusions and to reformulate axiogenic hypothesis.
沟通是医患互动的核心特征，也是一个常常存在问题的方面。倾听是如此基本，以至于我们往往将其视为理所当然。不幸的是，我们大多数人认为自己比实际情况更善于倾听。尤其令人苦恼的是，在那些我们指望能理解我们的人当中却有充耳不闻的情况。医生是有影响力的社会人物，人们期望他们在面对焦虑、不开心、失望、愤怒甚至疑病症患者时展现出恰当的技能。本文旨在对一种基于认知原则的访谈方法进行综述，该方法专门设计用于增强患者被倾听的感受，并建立一种工作关系。诸如非言语沟通、反思、总结和自我表露等技能是该方法的重要组成部分。患者对健康问题的情绪反应被视为是有效的，调查是基于患者对问题的认知而非医生的专业知识展开的。通过苏格拉底式提问，医生帮助患者得出自己的结论，并重新阐述病因假设。
