Street Richard L
Department of Speech Communication, Texas A&M University, College Station, TX 77843-4234, USA.
Patient Educ Couns. 2002 Dec;48(3):201-6. doi: 10.1016/s0738-3991(02)00171-4.
This article examines gender differences in health care provider-patient communication within the framework of an ecological model of communication in the medical encounter. The ecological perspective posits that, although health care provider-patient interactions are situated within a number of contexts (e.g. organizational, political, cultural), the interpersonal domain is the primary context within which these interactions unfold. Hence, gender may influence provider-patient interaction to the extent that it can be linked to the interactants' goals, skills, perceptions, emotions, and the way the participants adapt to their partner's communication. The evidence reviewed in this essay indicates that gender differences in medical encounters may come from several sources including differences in men's and women's communicative styles, perceptions of their partners, and in the way they accommodate their partner's behavior during the interaction. However, because gender is but one of many personal and partner variables (e.g. age, ethnicity, personal experiences) that can influence these processes, gender differences are often quite modest (if apparent at all) when examined across a population of health care providers and patients. Implications for future research and communicative skill training are discussed.
本文在医疗问诊中沟通的生态模型框架内，探讨了医疗服务提供者与患者沟通中的性别差异。生态视角认为，尽管医疗服务提供者与患者的互动处于多种背景（如组织、政治、文化）之中，但人际领域是这些互动展开的主要背景。因此，性别可能会影响医患互动，只要它能与互动者的目标、技能、认知、情感以及参与者适应其伙伴沟通的方式联系起来。本文所回顾的证据表明，医疗问诊中的性别差异可能源于多个方面，包括男性和女性沟通方式的差异、对其伙伴的认知以及在互动过程中他们适应伙伴行为的方式。然而，由于性别只是众多可能影响这些过程的个人和伙伴变量（如年龄、种族、个人经历）之一，当在全体医疗服务提供者和患者中进行考察时，性别差异往往相当微小（若真有差异的话）。文中还讨论了对未来研究和沟通技能培训的启示。
