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医患互动:土耳其的一家妇科诊所。

Physician-patient interaction: a gynecology clinic in Turkey.

作者信息

Uskul Ayse K, Ahmad Farah

机构信息

Psychology Department, Graduate Program, York University, 4700 Keele Street, Toronto, Ont, Canada, M3J 1P3.

出版信息

Soc Sci Med. 2003 Jul;57(2):205-15. doi: 10.1016/s0277-9536(02)00340-4.

Abstract

Evidence for gender differences in physicians' communication with their patients comes primarily from Western countries. Little is known about whether these gender differences would also be observed in Turkey, where there are explicit rules about male-female conduct. The purpose of this study was to observe male and female gynecologists' communication with their patients in a gynecology clinic at a state hospital in Istanbul, Turkey. Four male and three female gynecologists were observed in their interaction with 70 patients over 10 days. The observations were conducted during both the history taking and the actual examination sessions by a woman researcher. The results reported in this paper are based on the extensive field notes taken during the observations. Important differences were revealed in interactions between male vs female gynecologists and their patients. Namely, interactions differed in terms of conversation initiation, communication style, use of technical and colloquial language, frequency of eye contact, patience, and provision of information. Communication characteristics specific to interactions between male gynecologists and their patients included a 'blaming the victim' approach, differential treatment of patients, and underestimation of patients' abilities. Environmental factors that affected physicians' interaction with their patients are reported in conjunction with physicians' use of these external factors to explain the problems they experienced in physician-patient interaction. The discussion focuses on alternative explanations for and future research implications of the observed differences between male and female gynecologists in this setting.

摘要

关于医生与患者沟通中性别差异的证据主要来自西方国家。对于在土耳其是否也会观察到这些性别差异,人们知之甚少,因为土耳其有关于男女行为的明确规定。本研究的目的是观察土耳其伊斯坦布尔一家国立医院妇科诊所中男性和女性妇科医生与患者的沟通情况。在10天内,观察了4名男性和3名女性妇科医生与70名患者的互动。观察由一名女性研究人员在病史采集和实际检查过程中进行。本文报告的结果基于观察期间所做的大量实地记录。研究发现男性和女性妇科医生与患者的互动存在重要差异。具体而言,在对话开启、沟通方式、专业术语和口语的使用、眼神交流频率、耐心程度以及信息提供方面存在差异。男性妇科医生与患者互动的特定沟通特征包括“指责受害者”的方式、对患者的区别对待以及对患者能力的低估。报告了影响医生与患者互动的环境因素,并结合医生对这些外部因素的使用,来解释他们在医患互动中遇到的问题。讨论集中在对这种情况下男性和女性妇科医生之间观察到的差异的其他解释以及未来研究的意义。

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