Cegala D J, Marinelli T, Post D
School of Journalism and Communication, Ohio State University, Columbus, USA.
Arch Fam Med. 2000 Jan;9(1):57-64. doi: 10.1001/archfami.9.1.57.
To examine the relationship between communication skills training for patients and their compliance with recommended treatment.
A randomized control design was used, with patients nested within physicians. Each physician was audiotaped with 6 patients, 2 patients in each of the 3 intervention conditions: (1) a trained group (n = 50) received a training booklet in the mail 2 to 3 days prior to the scheduled appointment, (2) an informed group (n = 49) received a brief written summary of the major points contained in the training booklet while in the waiting room prior to the scheduled appointment, and (3) an untrained group (n = 51) did not receive any form of communication skills intervention.
Participants included physicians and patients from 9 different primary care, family practice locations. Two locations were clinics associated with a large, university-based medical school and hospital, while 7 were private practice offices in the community.
The sample included 25 family physicians (averaging 11 years postresidency) and 150 patients. Patients were randomly selected from appointment records and randomly assigned to 1 of 3 intervention conditions.
A training booklet designed to instruct patients in information seeking, provision, and verification.
Patients' compliance with medications, behavioral treatment (e.g., diet, exercise, smoking cessation), and/or follow-up appointments and referrals.
Trained patients were more compliant overall than untrained or informed patients. Training positively influenced compliance with behavioral treatments and follow-up appointments and referrals.
Training patients in communication skills may be a cost-effective way of increasing compliance and improving the overall health of patients.
研究患者沟通技能培训与其对推荐治疗的依从性之间的关系。
采用随机对照设计,患者嵌套于医生之中。每位医生与6名患者进行录音,在3种干预条件下各有2名患者:(1)训练组(n = 50)在预约前2至3天收到邮寄的培训手册;(2)告知组(n = 49)在预约前于候诊室收到培训手册主要内容的简要书面总结;(3)未训练组(n = 51)未接受任何形式的沟通技能干预。
参与者包括来自9个不同基层医疗、家庭医疗场所的医生和患者。其中2个场所是与一所大型大学附属医院相关的诊所,7个是社区私人诊所。
样本包括25名家庭医生(平均从业后11年)和150名患者。患者从预约记录中随机选取并随机分配到3种干预条件之一。
一本旨在指导患者进行信息寻求、提供和核实的培训手册。
患者对药物治疗、行为治疗(如饮食、运动、戒烟)和/或随访预约及转诊的依从性。
接受培训的患者总体上比未接受培训或仅被告知的患者依从性更高。培训对行为治疗及随访预约和转诊的依从性有积极影响。
对患者进行沟通技能培训可能是提高依从性和改善患者整体健康状况的一种经济有效的方法。