Department of Public Health and Community Medicine, University of Verona, Italy.
Patient Educ Couns. 2013 Mar;90(3):347-53. doi: 10.1016/j.pec.2011.06.010. Epub 2011 Jul 23.
to establish which kind of physician communicative responses to patient cues and concerns are appreciated by lay people.
A balanced sample (259 people) was recruited in public places to participate in a full day observation of four videotaped standardized medical consultations. In a two-step procedure participants gave their individual quality ratings of the whole consultations and then of a set of four fragments from each consultation. They contained a patient negative emotional expression and the subsequent physician response, according to the VR-CoDES.
Higher quality ratings were given to physician responses which provided space to the patient to talk and to the explicit expressions of empathy. The explicit responses were favored above non-explicit responses. Participants' global evaluation of the whole consultation affected their quality assessments of the fragments (halo-effect). In a multivariate model, lay people's background characteristics appeared to be relevant: to be female, of lower educational level and living in Belgium or Italy predicted higher ratings.
Providing space to patients is appreciated by all participants, combined with the need for tailor made communication.
To teach physicians listening skills and how to show empathy with distressed patients should be a core element in medical education.
确定哪些类型的医生对患者的暗示和关注的回应受到非专业人士的赞赏。
在公共场所招募了一个平衡的样本（259 人），让他们参与对四个录制好的标准化医疗咨询视频的全天观察。在两步程序中，参与者对整个咨询以及每个咨询的四个片段中的一个片段进行了单独的质量评分。根据 VR-CoDES，这些片段包含患者的负面情绪表达和随后医生的回应。
给予医生提供患者表达空间和明确表示同理心的回应更高的质量评分。明确的回应比非明确的回应更受欢迎。参与者对整个咨询的总体评价影响了他们对片段的质量评估（晕轮效应）。在多变量模型中，非专业人士的背景特征似乎是相关的：女性、教育程度较低、居住在比利时或意大利的人更倾向于给出更高的评分。
为患者提供表达空间是所有参与者都赞赏的，同时还需要量身定制的沟通方式。
教授医生倾听技巧和如何对痛苦的患者表示同理心应该是医学教育的核心内容。
