Travado Luzia, Grassi Luigi, Gil Francisco, Ventura Cidália, Martins Cristina
Clinical Psychology Unit, Centro Hospitalar de Lisboa zona central, Lisbon, Portugal.
Psychooncology. 2005 Aug;14(8):661-70. doi: 10.1002/pon.890.
Physician-patient communication is a critical factor for comprehensive care in oncology. Although a number of studies have been carried out in Northern Europe and the US on this subject, no data are available in Southern European countries. As a part of a multicenter Southern European Psycho-Oncology study (SEPOS), the present investigation was conducted to examine communication skills and related variables (i.e. psychosocial orientation, and burnout) among 125 physicians from Italy, Portugal, and Spain. The Self-Confidence in Communication Skills (SCCS) scale was given to assess physicians' perception of their communication skills and the Expected Outcome of Communication (EOC) scale was administered to examine the physicians' expectations about the effects of communicating with their patients. Doctors' psychosocial orientation was measured by using the Physician Belief Scale (PBS) and burnout was measured by using the Maslach Burnout Inventory (MBI). Although the physicians reported receiving minimal training in communication during their education, they tended to perceive themselves as skilled in patient communication, apart from some areas (e.g. dealing with denial, managing uncertainty, assessing anxiety and depression, and promoting patient-family openness). Low psychosocial orientation and burnout symptoms (i.e. emotional exhaustion, depersonalization, and poor personal accomplishment in their job) were associated with lower confidence in communication skills and higher expectations of a negative outcome, following physician-patient communication. The results suggest that there is a need for training cancer physicians in communication and for increasing a more definite psychosocially oriented approach in cancer care in Mediterranean countries.
医患沟通是肿瘤综合治疗的关键因素。尽管北欧和美国已经针对这一主题开展了多项研究，但南欧国家尚无相关数据。作为南欧多中心心理肿瘤学研究（SEPOS）的一部分，本调查旨在研究来自意大利、葡萄牙和西班牙的125名医生的沟通技巧及相关变量（即心理社会取向和职业倦怠）。使用沟通技能自信量表（SCCS）来评估医生对自身沟通技巧的认知，并使用沟通预期结果量表（EOC）来考察医生对与患者沟通效果的期望。通过医生信念量表（PBS）来衡量医生的心理社会取向，并使用马氏职业倦怠量表（MBI）来测量职业倦怠。尽管医生们表示在教育期间接受的沟通培训极少，但除了某些方面（如应对否认、处理不确定性、评估焦虑和抑郁以及促进患者与家属的坦诚交流）外，他们倾向于认为自己在与患者沟通方面有能力。心理社会取向较低和存在职业倦怠症状（即情感耗竭、去人格化以及工作中个人成就感低）与沟通技能自信较低以及医患沟通后对负面结果的较高期望相关。结果表明，地中海国家的肿瘤医生需要接受沟通培训，并在癌症治疗中增加更明确的心理社会导向方法。
