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换位思考是否能提高医患接触中的患者满意度?

Does perspective-taking increase patient satisfaction in medical encounters?

机构信息

Department of Medicine, CLASS Clinical Skills Center, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

出版信息

Acad Med. 2010 Sep;85(9):1445-52. doi: 10.1097/ACM.0b013e3181eae5ec.

Abstract

PURPOSE

To assess whether perspective-taking, which researchers in other fields have shown to induce empathy, improves patient satisfaction in encounters between student-clinicians and standardized patients (SPs).

METHOD

In three studies, randomly assigned students (N = 608) received either a perspective-taking instruction or a neutral instruction prior to a clinical skills examination in 2006-2007. SP satisfaction was the main outcome in all three studies. Study 1 involved 245 third-year medical students from two universities. Studies 2 and 3 extended Study 1 to examine generalizability across student and SP subpopulations. Study 2 (105 physician assistant students, one university) explored the effect of perspective-taking on African American SPs' satisfaction. Study 3 (258 third-year medical students, two universities) examined the intervention's effect on students with high and low baseline perspective-taking tendencies.

RESULTS

Intervention students outscored controls in patient satisfaction in all studies: Study 1: P = .01, standardized effect size = 0.16; Study 2: P = .001, standardized effect size = 0.31; Study 3: P = .009, standardized effect size = 0.13. In Study 2, perspective-taking improved African American SPs' satisfaction. In Study 3, intervention students with high baseline perspective-taking tendencies outscored controls (P = .0004, standardized effect size = 0.25), whereas those with low perspective-taking tendencies did not (P = .72, standardized effect size = 0.00).

CONCLUSIONS

Perspective-taking increased patient satisfaction in all three studies, across medical schools, clinical disciplines, and racially diverse students and SPs. Perspective-taking as a means for improving patient satisfaction deserves further exploration in clinical training and practice.

摘要

目的

评估换位思考——其他领域的研究人员已证实其能引发同理心——是否能提高学生临床医生与标准化患者(SP)之间互动中的患者满意度。

方法

在三项研究中,2006-2007 年,在临床技能考试前,随机分配的学生(N=608)接受换位思考指导或中性指导。所有三项研究的主要结果都是 SP 的满意度。研究 1 涉及来自两所大学的 245 名三年级医学生。研究 2 和研究 3 将研究 1 扩展到检验学生和 SP 亚群中的可推广性。研究 2(105 名医师助理学生,一所大学)探讨了换位思考对非裔美国 SP 满意度的影响。研究 3(258 名三年级医学生,两所大学)检验了该干预措施对基线换位思考倾向高和低的学生的影响。

结果

在所有研究中,干预组学生的患者满意度均高于对照组:研究 1:P=0.01,标准化效应大小=0.16;研究 2:P=0.001,标准化效应大小=0.31;研究 3:P=0.009,标准化效应大小=0.13。在研究 2 中,换位思考提高了非裔美国 SP 的满意度。在研究 3 中,基线换位思考倾向高的干预组学生的得分高于对照组(P=0.0004,标准化效应大小=0.25),而倾向低的学生则没有(P=0.72,标准化效应大小=0.00)。

结论

在所有三项研究中,换位思考都提高了患者的满意度,涵盖了医学院、临床学科和不同种族的学生和 SP。作为提高患者满意度的一种手段,换位思考值得在临床培训和实践中进一步探索。

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