Post D M, Cegala D J, Marinelli T M
Department of Family Medicine, Department of Communication and Family Medicine, and Children's Hospital Research Foundation, Ohio State University, Columbus, Ohio, USA.
J Natl Med Assoc. 2001 Jan;93(1):6-12.
Research on physician-patient communication has focused on the effect of physician communication training on health care outcomes. Much less is known about patient communication training, and even less about the impact of patient race on the effectiveness of patient communication interventions. One hundred and fifty patients of 25 family physicians were randomly assigned to one of three groups: 14-page patient communication workbook received 2-3 days pre-visit, 2-page patient communication handout received in the waiting room, or control group. Racial differences in the impact of patient communication training communication variables, immediate and delayed recall of information, and adherence to treatment were analyzed by t-test and ANOVA techniques. Across analyses, workbook communication skills training had a strong and significant effect on white patients but minimal or no effect on African-American patients. Minimal differences in dependent variables between racial groups existed for the patient handout and control groups. A partial correlation analysis was conducted to factor out the variance due to education. Results suggested that patient race accounted for the results over and above differences in education between racial groups. Our results suggested that the benefits of communication training can be enhanced by taking into account patient characteristics such as race and culture.
关于医患沟通的研究主要集中在医生沟通培训对医疗保健结果的影响上。对于患者沟通培训的了解要少得多，而关于患者种族对患者沟通干预效果的影响则知之更少。25位家庭医生的150名患者被随机分为三组：在就诊前2 - 3天收到14页患者沟通工作手册的组、在候诊室收到2页患者沟通手册的组或对照组。通过t检验和方差分析技术分析了患者沟通培训沟通变量、信息的即时和延迟回忆以及治疗依从性方面的种族差异。在各项分析中，工作手册沟通技能培训对白人患者有强烈且显著的影响，但对非裔美国患者影响极小或没有影响。患者手册组和对照组在种族群体之间的因变量差异极小。进行了偏相关分析以排除教育因素导致的方差。结果表明，除了种族群体之间的教育差异外，患者种族也对结果产生影响。我们的结果表明，通过考虑种族和文化等患者特征，可以提高沟通培训的益处。
