Libert Yves, Merckaert Isabelle, Reynaert Christine, Delvaux Nicole, Marchal Serge, Etienne Anne-Marie, Boniver Jacques, Klastersky Jean, Scalliet Pierre, Slachmuylder Jean-Louis, Razavi Darius
Université Libre de Bruxelles, Av. F. Roosevelt, 50, CP 191, 1050, Brussels, Belgium.
Support Care Cancer. 2006 Mar;14(3):230-42. doi: 10.1007/s00520-005-0871-y. Epub 2005 Jul 29.
Physicians' psychological characteristics may influence their communication styles and may thus interfere with patient-centred communication.
Our aim was to test the hypothesis that, in interviews with a cancer patient and a relative, physicians with an "external" locus of control (LOC; who believe that life outcomes are controlled by external forces such as luck, fate or others) have a communication style different from that of physicians with an "internal" LOC (who believe that life outcomes are controlled by their own characteristics or actions).
DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: Eighty-one voluntary physicians practising in the field of oncology were recorded while performing an actual and a simulated interview with a cancer patient and a relative.
Physicians' communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians' LOC was assessed using the Rotter I-E scale. The communication skills of the upper and lower quartiles of physicians in respect of their scores on this scale were compared using Student's t test.
In actual interviews, physicians with an "external" LOC talked more to the relative (P=0.017) and used more utterances with an assessment function (P=0.010) than physicians with an "internal" LOC. In simulated interviews, physicians with an "external" LOC used less utterances that give premature information (P=0.031) and used more utterances with a supportive function, such as empathy and reassurance (P=0.029), than physicians with an "internal" LOC.
These results provide evidence that physicians' LOC can influence their communication styles. Physicians' awareness of this influence constitutes a step towards a tailoring of their communication skills to every patient's and relative's concerns and needs and thus towards a patient-centred communication.
医生的心理特征可能会影响他们的沟通方式，从而干扰以患者为中心的沟通。
我们的目的是检验这样一个假设，即在与癌症患者及其亲属的访谈中，具有“外部”控制点（LOC；即认为生活结果受运气、命运或他人等外部力量控制）的医生与具有“内部”LOC（即认为生活结果受自身特征或行为控制）的医生的沟通方式不同。
设计、场所、参与者和干预措施：81名从事肿瘤学领域工作的志愿医生在对一名癌症患者及其亲属进行实际访谈和模拟访谈时被录音。
使用癌症研究运动研讨会评估手册评估医生的沟通技巧。使用罗特内外控量表评估医生的控制点。使用学生t检验比较在该量表上得分处于上四分位数和下四分位数的医生的沟通技巧。
在实际访谈中，具有“外部”LOC的医生与亲属交谈的更多（P = 0.017），并且比具有“内部”LOC的医生使用更多具有评估功能的话语（P = 0.010）。在模拟访谈中，具有“外部”LOC的医生使用提供过早信息的话语较少（P = 0.031），并且比具有“内部”LOC的医生使用更多具有支持功能的话语，如同理心和安慰（P = 0.029）。
这些结果提供了证据表明医生的控制点可以影响他们的沟通方式。医生意识到这种影响是朝着根据每个患者及其亲属的关注点和需求调整他们的沟通技巧迈出的一步，从而朝着以患者为中心的沟通迈进。
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