Street R L
Department of Speech Communication, Texas A&M University, College Station 77843-4234.
Soc Sci Med. 1991;32(5):541-8. doi: 10.1016/0277-9536(91)90288-n.
Informing the patient is arguably the physician's most important communicative responsibility. Recognizing this researchers have long been interested in the question of why some patients receive more information from physicians than do others. In this paper, it is argued that the amount of information physicians provide patients during medical consultations may be influenced by two sets of factors, patients' personal characteristics (age, sex, education, and anxiety) and patients' communicative styles (question-asking, opinion-giving, and expression of concern). The analysis of audiovisual recordings of 41 physician-patient consultations in a family practice clinic revealed several notable findings: (a) information regarding diagnosis and health matters was primarily related to the patient's anxiety, education, and question-asking, (b) information regarding treatment was primarily a function of the patient's question-asking and expression of concerns, and (c) patients' assertiveness and expressiveness were strongly influenced by physicians' use of 'partnership-building' utterances that solicited the patient's questions, concerns, and opinions. The data suggest that, when attempting to explicate factors affecting physicians' informativeness, researchers must take into account features of the patients' communicative styles as well as physicians' perceptions of certain groups of patients.
告知患者可以说是医生最重要的沟通责任。认识到这一点后，研究人员长期以来一直对为何有些患者从医生那里获得的信息比其他患者更多这一问题感兴趣。本文认为，医生在医疗咨询过程中向患者提供的信息量可能受到两组因素的影响，即患者的个人特征（年龄、性别、教育程度和焦虑程度）以及患者的沟通方式（提问、发表意见和表达关切）。对一家家庭诊所41次医患咨询的视听记录进行分析后发现了几个值得注意的结果：（a）关于诊断和健康问题的信息主要与患者的焦虑程度、教育程度和提问有关；（b）关于治疗的信息主要取决于患者的提问和表达关切的程度；（c）患者的自信和表达能力受到医生使用“建立伙伴关系”话语的强烈影响，这些话语会征求患者的问题、关切和意见。数据表明，在试图阐明影响医生信息提供程度的因素时，研究人员必须考虑患者沟通方式的特点以及医生对特定患者群体的看法。
