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[以患者为中心的访谈及其教学方式。近期获得学位的家庭医生是怎么看的?]

[The patient-centered interview and the way it is taught. What do family physicians who have recently received their degree think?].

作者信息

Côté Luc, Bélanger Norma, Blais Johanne

机构信息

Département de médecine familiale, Centre de développement pédagogique, Faculté de médecine, l'Université Laval à Ste-Foy, Québec.

出版信息

Can Fam Physician. 2002 Nov;48:1800-5.

PMID:12489245
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2213960/
Abstract

OBJECTIVE

To describe how family physicians perceive the patient-centred interview (PCI) and the way in which it is taught during residency training. DESIGN: Mailed survey. SETTING: Family physicians from a variety of practice settings in Quebec. PARTICIPANTS: Ninety-one family physicians who graduated from Laval University between 1996 and 1998. METHOD: Survey was conducted in 1999 using the modified Dillman method. The original questionnaire had mainly open-ended questions on perception of the PCI and learning activities associated with it during residency training. All qualitative data were subject to content analysis using triangulation strategies. MAIN FINDINGS: A PCI mainly involves exploring patients' experience of their illnesses; this helps physicians to better understand patients. Patients are more content with this type of interview and are, therefore, more likely to follow physicians' recommendations. Respondents reported the main drawback to be longer interview times; this was particularly true for emergency and walk-in care. The most useful learning activities during residency were reported to be supervision by direct observation and observation of supervisor-patient consultations. CONCLUSION: Patient-centred interviews enabled physicians to understand and help their patients better. Results of this study can help teachers who are developing and consolidating activities to teach residents how to conduct PCIs and how to integrate them into practice.

摘要

目的

描述家庭医生如何看待以患者为中心的问诊(PCI)以及住院医师培训期间教授该问诊方式的方法。

设计

邮寄调查。

背景

来自魁北克各种执业环境的家庭医生。

参与者

1996年至1998年间从拉瓦尔大学毕业的91名家庭医生。

方法

1999年采用改良的迪尔曼方法进行调查。原始问卷主要包含关于对PCI的看法以及住院医师培训期间与之相关的学习活动的开放式问题。所有定性数据均采用三角测量策略进行内容分析。

主要发现

PCI主要涉及探究患者对自身疾病的体验;这有助于医生更好地理解患者。患者对这种问诊方式更满意,因此更有可能遵循医生的建议。受访者报告的主要缺点是问诊时间较长;在急诊和即时护理中尤其如此。据报告,住院医师培训期间最有用的学习活动是直接观察监督和观察上级医生与患者的会诊。

结论

以患者为中心的问诊使医生能够更好地理解和帮助患者。本研究结果可帮助正在开展和巩固相关活动的教师,教导住院医师如何进行PCI以及如何将其融入实践。

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The doctor will see you shortly. The ethical significance of time for the patient-physician relationship.医生很快就会来见你。时间对医患关系的伦理意义。
J Gen Intern Med. 2005 Nov;20(11):1057-62. doi: 10.1111/j.1525-1497.2005.00217.x.

本文引用的文献

1
Training in Psychosocial Issues: Survey of family medicine graduates.心理社会问题培训:家庭医学毕业生调查。
Can Fam Physician. 1992 Apr;38:806-12.
2
Towards a global definition of patient centred care.迈向以患者为中心的医疗的全球定义。
BMJ. 2001 Feb 24;322(7284):444-5. doi: 10.1136/bmj.322.7284.444.
3
How clinical teachers perceive the doctor-patient relationship and themselves as role models.临床教师如何看待医患关系以及他们自身作为榜样的角色。
Acad Med. 2000 Nov;75(11):1117-24. doi: 10.1097/00001888-200011000-00020.
4
Patient-centredness: a conceptual framework and review of the empirical literature.以患者为中心:一个概念框架及实证文献综述
Soc Sci Med. 2000 Oct;51(7):1087-110. doi: 10.1016/s0277-9536(00)00098-8.
5
Evidence on patient-doctor communication.关于医患沟通的证据。
Cancer Prev Control. 1999 Feb;3(1):25-30.
6
[Physician-patient relations in family medicine].[家庭医学中的医患关系]
Can Fam Physician. 1999 May;45:1250-4.
7
[Physician patient relationship apprenticeship. Direct supervision of II residents in a family medicine unit].[医患关系学徒制。在家庭医学科对两名住院医师进行直接监督]
Can Fam Physician. 1993 Sep;39:2006-12.
8
Effective physician-patient communication and health outcomes: a review.有效的医患沟通与健康结局:综述
CMAJ. 1995 May 1;152(9):1423-33.
9
Nature of the clinical difficulties of first-year family medicine residents under direct observation.直接观察下的一年级家庭医学住院医师临床困难的性质
CMAJ. 1992 Feb 15;146(4):489-97.