Feldman-Stewart D, Brundage M D, Tishelman C
Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Ontario, Canada.
Psychooncology. 2005 Oct;14(10):801-9; discussion 810-1. doi: 10.1002/pon.950.
We present a conceptual framework of one-to-one, in-person communication that occurs between a health-care professional and a patient. The framework is intended as a tool for organizing and summarizing relevant research but it can also help guide assessing the communication process and can help guide development of interventions to improve the process. The framework includes four key components, with a focus on elements that can be modified. The first component is the focus of the interaction: each participant's communication goals. The second component consists of the participants themselves, each with five key attributes that determine, in part, how they address their goals. The third component is the communication process: each person both conveys messages and receives messages, and the messages themselves can be verbal, non-verbal, or silent. The communication process is iterative and extended in time with one act having an impact on following acts. Finally, the fourth component is the environment in which the communication occurs, both the immediate physical setting and the context beyond. Important aspects of the environment, identified as external factors, affect the communication process through their impact on the participants' attributes. The framework builds on classic communication frameworks to which it adds unique elements. Some of its unique aspects include the prominent role of the participants' goals and its distinct recognition that messages are conveyed through silence. The framework serves as a common conceptualization of factors important to successful communication for the remaining review papers in this series and for future studies of practitioner-patient communication.
我们提出了一个关于医疗保健专业人员与患者之间进行的一对一、面对面交流的概念框架。该框架旨在作为一种工具，用于组织和总结相关研究，但它也有助于指导对交流过程的评估，并有助于指导改善该过程的干预措施的制定。该框架包括四个关键组成部分，重点关注可以修改的要素。第一个组成部分是互动的焦点：每个参与者的交流目标。第二个组成部分由参与者自身构成，每个人都有五个关键属性，这些属性在一定程度上决定了他们如何实现自己的目标。第三个组成部分是交流过程：每个人既传达信息又接收信息，而信息本身可以是言语的、非言语的或无声的。交流过程是反复的且在时间上是延伸的，一个行为会对后续行为产生影响。最后，第四个组成部分是交流发生的环境，包括直接的物理环境和更广泛的背景。被确定为外部因素的环境的重要方面，通过对参与者属性的影响来影响交流过程。该框架建立在经典交流框架的基础上，并增添了独特的要素。其一些独特之处包括参与者目标的突出作用以及对通过沉默传达信息的明确认可。该框架作为对本系列其余综述论文以及未来医患交流研究中成功交流重要因素的一种共同概念化表述。
