Thom D H
Family and Community Medicine, Stanford University School of Medicine, Palo Alto, CA 94304-1760, USA.
J Eval Clin Pract. 2000 Aug;6(3):245-53. doi: 10.1046/j.1365-2753.2000.00249.x.
Patient trust in the physician is an important aspect of the patient-physician relationship that has recently become a focus of interest, in part due to the rise of managed care in the US healthcare system. In a previous study, we identified physician behaviours reported by patients as important to establishing their trust in the physician. The current study attempted to modify these behaviours via a short training programme and thereby to increase patient trust and improve associated outcomes. After baseline measurements, 10 physicians were randomized to the intervention group and 10 remained as a control group. While intervention physicians showed a net improvement in 16 of 19 specific patient-reported behaviours when compared to control physicians, these differences were not statistically significant. There was also no significant difference in patient trust, patient satisfaction, continuity, self-reported adherence, number of referrals or number of diagnostic tests ordered. This short training course in a group of self-selected physicians was not a sufficiently strong intervention to achieve the desired effect. Suggestions are given for designing a stronger training intervention.
患者对医生的信任是医患关系的一个重要方面，最近已成为人们关注的焦点，部分原因是美国医疗保健系统中管理式医疗的兴起。在之前的一项研究中，我们确定了患者报告的对建立他们对医生信任很重要的医生行为。当前的研究试图通过一个简短的培训项目来改变这些行为，从而提高患者的信任并改善相关结果。在进行基线测量后，10名医生被随机分配到干预组，10名作为对照组。与对照医生相比，干预医生在19项患者报告的特定行为中有16项有净改善，但这些差异无统计学意义。在患者信任、患者满意度、连续性、自我报告的依从性、转诊数量或所开诊断测试数量方面也没有显著差异。在一组自我选择的医生中进行的这个简短培训课程并不是一个足够有力的干预措施来达到预期效果。文中给出了设计更强有力培训干预措施的建议。
