van Dulmen A M, van Weert J C
Netherlands Institute of Health Services Research, Utrecht.
BJOG. 2001 May;108(5):485-91. doi: 10.1111/j.1471-0528.2001.00104.x.
To investigate the effects of an experimental communication course on how gynaecologists handle psychosocial issues in gynaecological consultation.
Pre-post testing. Multilevel analysis was used to take into account the similarity among encounters with the same gynaecologist.
Eighteen gynaecologists (13 consultants and 5 junior doctors) from five different hospitals participated. All gynaecologists videotaped consecutive outpatient encounters before and after attending an intensive training course.
The communicative performance of the gynaecologists at pre-and post measurement.
The gynaecologists recorded a total of 526 outpatient encounters, 272 before and 254 after the training. As a result of the training, gynaecologists' sensitivity to psychosocial aspects of their patients increased. At post measurement, the gynaecologists gave more signs of agreement, became less directive, asked fewer medical questions and more psychosocial questions. No difference was found in the duration of the outpatient visits. With the trained gynaecologists, patients asked more questions and provided more psychosocial information.
Junior doctors and clinically experienced gynaecologists can be taught to handle psychosocial issues without lengthening the visit.
探讨一门实验性沟通课程对妇科医生在妇科会诊中处理心理社会问题方式的影响。
前后测试。采用多水平分析以考虑同一位妇科医生会诊之间的相似性。
来自五家不同医院的18名妇科医生（13名顾问医生和5名初级医生）参与。所有妇科医生在参加强化培训课程前后对连续的门诊会诊进行录像。
妇科医生在测量前后的沟通表现。
妇科医生共记录了526次门诊会诊，培训前272次，培训后254次。培训后，妇科医生对患者心理社会方面的敏感度增加。在测量后，妇科医生给出更多认同的表示，指令性减少，提出的医学问题减少，心理社会问题增多。门诊会诊时长未发现差异。对于接受培训的妇科医生，患者提出更多问题并提供更多心理社会信息。
可以教会初级医生和临床经验丰富的妇科医生处理心理社会问题而不延长会诊时间。
