van Dulmen Sandra
NIVEL, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
Patient Educ Couns. 2004 Jan;52(1):61-8. doi: 10.1016/s0738-3991(02)00250-1.
Pediatricians are generally confronted with a variety of health problems. Each of these problems may benefit from another pattern of healthcare communication. It is unknown whether the communication process during pediatric visits actually differs by the nature of the child's problem. This study first examined whether three formerly identified communication patterns could be distinguished within real-life pediatric outpatient encounters (N=846). Then, communication patterns during encounters with children with respiratory (n=269) or behavioral problems (n=77) were compared. Videotaped visits were observed using the Roter Interaction Analysis System. Two-level multivariate logistic regression analysis examined what factors contributed to the communication patterns. A biopsychosocial communication pattern was observed in 45%, a psychosocial in 15% and a biomedical pattern in 40% of the visits. Child's age and pediatrician's experience were related to the communication pattern. Different patterns did indeed prevail in respiratory and behavioral problems. As less experienced pediatricians attend to psychosocial issues less, they may have to be specifically encouraged to do so.
儿科医生通常会面临各种各样的健康问题。这些问题中的每一个都可能受益于另一种医疗沟通模式。尚不清楚儿科就诊期间的沟通过程是否真的因儿童问题的性质而异。本研究首先考察了在现实生活中的儿科门诊就诊（N = 846）中是否可以区分出三种先前确定的沟通模式。然后，比较了与患有呼吸系统疾病（n = 269）或行为问题（n = 77）的儿童就诊时的沟通模式。使用罗特互动分析系统对录像就诊进行观察。两级多变量逻辑回归分析考察了哪些因素促成了沟通模式。在45%的就诊中观察到生物心理社会沟通模式，15%为心理社会模式，40%为生物医学模式。儿童年龄和儿科医生的经验与沟通模式有关。不同模式在呼吸系统和行为问题中确实占主导地位。由于经验不足的儿科医生较少关注心理社会问题，可能需要特别鼓励他们这样做。
