Talvitie Ulla, Pyöriä Outi
Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
Health Commun. 2006;20(2):187-96. doi: 10.1207/s15327027hc2002_10.
Studies on the interaction between physiotherapists and patients during treatment sessions have found low levels of communicative participation by patients and lack of direct influence by patients on the content of their treatment. This article reports the results of 7 counseling sessions in which physiotherapists and patients with stroke and their caregivers discussed the patients' postural control and balance, which had been tested and videotaped at different stages of the rehabilitation process. The physiotherapists' discourses relating to the videotaped test performances were either brief comments on the patient's performance or critical appraisals with references to difficulties encountered during performance. Performances of the easier tasks were treated by the physiotherapists with rhetorical questions. The second type of discourse consisted of the physiotherapists directing the patients' attention to their problems, and of the patients' and caregivers' initiatives leading to conversation about the patients' problems. The patients understood the significance of the test performance for their life at home in varying ways. The results of this study showed that successful counseling calls for physiotherapists to develop dialogic communication skills to help patients in coconstructing their home exercise together with their social network.
对治疗过程中物理治疗师与患者之间互动的研究发现，患者的沟通参与度较低，且患者对其治疗内容缺乏直接影响。本文报告了7次咨询会议的结果，在这些会议中，物理治疗师与中风患者及其护理人员讨论了患者的姿势控制和平衡，这些在康复过程的不同阶段都经过了测试并录制了视频。物理治疗师关于录像测试表现的论述要么是对患者表现的简短评论，要么是对表现过程中遇到的困难进行批判性评估。对于较简单任务的表现，物理治疗师会用反问句来处理。第二种论述包括物理治疗师引导患者关注自身问题，以及患者和护理人员主动引发关于患者问题的对话。患者对测试表现对其居家生活的重要性有不同程度的理解。这项研究的结果表明，成功的咨询要求物理治疗师培养对话沟通技巧，以帮助患者与他们的社交网络共同构建家庭锻炼计划。
