Fassaert Thijs, van Dulmen Sandra, Schellevis François, Bensing Jozien
NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.
Patient Educ Couns. 2007 Nov;68(3):258-64. doi: 10.1016/j.pec.2007.06.011. Epub 2007 Aug 3.
Active listening is a prerequisite for a successful healthcare encounter, bearing potential therapeutic value especially in clinical situations that require no specific medical intervention. Although generally acknowledged as such, active listening has not been studied in depth. This paper describes the development of the Active Listening Observation Scale (ALOS-global), an observation instrument measuring active listening and its validation in a sample of general practice consultations for minor ailments.
Five hundred and twenty-four videotaped general practice consultations involving minor ailments were observed with the ALOS-global. Hypotheses were tested to determine validity, incorporating patients' perception of GPs' affective performance, GPs' verbal attention, patients' self-reported anxiety level and gender differences.
The final 7-item ALOS-global had acceptable inter- and intra-observer agreement. Factor analysis revealed one homogeneous dimension. The scalescore was positively related to verbal attention measured by RIAS, to patients' perception of GPs' performance and to their pre-visit anxiety level. Female GPs received higher active listening scores.
The results of this study are promising concerning the psychometric properties of the ALOS-global. More research is needed to confirm these preliminary findings.
After establishing how active listening differentiates between health professionals, the ALOS-global may become a valuable tool in feedback and training aimed at increasing listening skills.
积极倾听是成功的医疗服务过程的一个前提条件,尤其在不需要特定医疗干预的临床情境中具有潜在的治疗价值。尽管人们普遍认可这一点,但积极倾听尚未得到深入研究。本文描述了积极倾听观察量表(ALOS-global)的开发过程,这是一种用于测量积极倾听的观察工具,并在针对小病的全科医疗咨询样本中对其进行了验证。
使用ALOS-global对524次涉及小病的全科医疗咨询录像进行观察。对假设进行了检验以确定效度,其中纳入了患者对全科医生情感表现的感知、全科医生的言语关注、患者自我报告的焦虑水平以及性别差异。
最终的7项ALOS-global具有可接受的观察者间和观察者内一致性。因子分析揭示了一个同质维度。量表得分与RIAS测量的言语关注、患者对全科医生表现的感知以及他们就诊前的焦虑水平呈正相关。女全科医生的积极倾听得分更高。
关于ALOS-global的心理测量特性,本研究结果很有前景。需要更多研究来证实这些初步发现。
在确定积极倾听如何区分健康专业人员之后,ALOS-global可能成为旨在提高倾听技巧的反馈和培训中的一个有价值的工具。