Portland VA Medical Center, Portland, OR, USA.
Patient Educ Couns. 2011 Sep;84(3):386-92. doi: 10.1016/j.pec.2011.04.023. Epub 2011 May 19.
To assess the impact of patient-centered communication (PCC) behaviors on patients' evaluations of physicians and acceptance of clinical recommendations.
We randomized 248 patients to view video-recorded, standardized vignettes, depicting a cardiologist using a high vs. low degree of PCC while recommending bypass surgery to a patient with angina and 3-vessel coronary artery disease. We compared patients' ratings of the physician and their decision making in response to the physician's recommendation, for high vs. low PCC vignettes.
Patients viewing high PCC vignettes rated the video physician more favorably overall (3.01 vs. 2.12, p<0.001) and as more competent (3.22 vs. 2.66, p<0.001) and trustworthy (2.93 vs. 2.28, p<0.001) than those viewing the low PCC version (0-4 range for all scales). Patients viewing the high PCC version more frequently said they would undergo bypass surgery (96% vs. 74%, p<0.001) if they were the patient in the video.
Patients expressed greater confidence in physicians who used more PCC behaviors, and greater willingness to accept an evidence-based recommendation.
PCC may make physicians more effective in the delivery of evidence-based care.
评估以患者为中心的沟通（PCC）行为对患者对医生的评价和对临床建议的接受程度的影响。
我们将 248 名患者随机分为两组，分别观看描绘一名心脏病专家在推荐旁路手术给一名心绞痛和三支血管病变患者时使用高度和低度 PCC 的视频记录标准化情景。我们比较了患者对医生的评分以及他们对医生建议的决策，以高 PCC 与低 PCC 情景为例。
观看高 PCC 情景的患者总体上对视频医生的评价更高（3.01 比 2.12，p<0.001），认为医生更有能力（3.22 比 2.66，p<0.001）和值得信赖（2.93 比 2.28，p<0.001），而观看低 PCC 版本的患者则不然（所有量表的范围为 0-4）。观看高 PCC 版本的患者更频繁地表示，如果他们是视频中的患者，他们更愿意接受旁路手术（96%比 74%，p<0.001）。
患者对使用更多 PCC 行为的医生表示出更大的信心，并且更愿意接受基于证据的建议。
PCC 可能使医生在提供基于证据的护理方面更有效。
