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[基层医疗卫生机构门诊中的医患关系]

[Physician-patient relations in the outpatient clinic of primary health care units].

作者信息

Cuevas-Urióstegui M L, Avila-Martínez I, Oliver-Márquez J, Sumano-Catalán M, Palomares-Hernández G, Garduño-Espinosa J

机构信息

Instituto Nacional de la Nutrición Salvador Zubirán, México.

出版信息

Salud Publica Mex. 1991 Nov-Dec;33(6):576-84.

PMID:1805385
Abstract

The objective of this study was to determine the degree of concordance between physicians and patients at primary health care units with regard to different aspects of medical consultation. The research design was a descriptive survey. The study units were the primary health care units of the Ministry of Health located in the "Gustavo A. Madero" district. 76 patients were interviewed as well as those physicians who gave consultations. A questionnaire was administered to those patients. It included six questions on the following aspects: physical examination, explanation regarding illness and drug prescription, degree of compliance by patients, duration of consultation and an estimation to know if the physician-patient relationship was satisfactory. For these measurements a analogue-visual scale and a semantic differential scale were used. A great variation was found in the correlation between physician and patient. The major degree of concordance was obtained in the way the relationship was perceived by each other (rs = 0.18); the estimation of compliance (rs = 0.10) and the explanation about illness (rs = 0.08). A tendency to disagreement was perceived in the physical examination (rs = 0.18), the duration of consultation (rs = 0.10) and the explanation about drugs (rs = -0.02). A larger degree of agreement was observed when the physician was less than 40 years old, when he had no specialty and when the patients was also less than 40 years old.

摘要

本研究的目的是确定初级卫生保健单位的医生与患者在医疗咨询不同方面的一致程度。研究设计为描述性调查。研究单位是位于“古斯塔沃·A·马德罗”区的卫生部初级卫生保健单位。对76名患者以及进行诊疗的医生进行了访谈。对这些患者发放了一份问卷。问卷包括关于以下方面的六个问题:体格检查、疾病解释和药物处方、患者的依从程度、诊疗时长以及对医患关系是否满意的评估。对于这些测量,使用了视觉模拟量表和语义差异量表。发现医生与患者之间的相关性存在很大差异。在双方对关系的认知方式上一致性程度最高(rs = 0.18);在依从性评估(rs = 0.10)和疾病解释方面(rs = 0.08)。在体格检查(rs = 0.18)、诊疗时长(rs = 0.10)和药物解释方面(rs = -0.02)存在不一致的倾向。当医生年龄小于40岁、没有专业特长且患者年龄也小于40岁时,观察到的一致程度更高。

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