Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.
Patient. 2009 Jun 1;2(2):77-84. doi: 10.2165/01312067-200902020-00003.
Over the past 3-4 decades, numerous studies have been published evaluating interventions targeted at healthcare providers, at patients, or at both patients and healthcare providers, which are designed to, in some fashion, improve the provider-patient relationship and thereby enhance patient health outcomes. This article synthesizes findings from 14 literature reviews of relevant studies published between 1991 and 2007. Findings indicate that interventions aimed at physicians and other providers have consistently produced positive effects on provider communication behaviors and interpersonal skills. However, only moderately positive effects on patient satisfaction, and limited impact on patient healthcare behaviors such as compliance, appointment adherence, and resource use were found. Effects on primary medical outcomes were minimal although some positive effects on secondary medical outcomes such as quality of life were obtained. Patient-targeted interventions also showed consistently positive effects on patient-physician communication in addition to enhanced patient participation in decision making. Effects on patient primary medical outcomes were limited, and weak effects on patient satisfaction were obtained. Characteristics of studies and training programs that may have influenced outcomes are discussed, as are practical impediments to promoting better physician-patient communication in clinical practice.
在过去的 30 到 40 年中，已经有许多研究发表，评估针对医疗保健提供者、患者或患者和医疗保健提供者的干预措施，这些措施旨在以某种方式改善医患关系，从而提高患者的健康结果。本文综合了 1991 年至 2007 年间发表的 14 篇相关研究文献综述的结果。研究结果表明，针对医生和其他提供者的干预措施始终对提供者的沟通行为和人际交往技能产生积极影响。然而，仅发现对患者满意度有适度的积极影响，对患者的医疗保健行为（如依从性、预约遵守和资源使用）的影响有限。对主要医疗结果的影响很小，尽管对生活质量等次要医疗结果获得了一些积极影响。针对患者的干预措施除了增强患者参与决策外，还对医患沟通始终显示出积极影响。对患者主要医疗结果的影响有限，对患者满意度的影响较弱。讨论了可能影响结果的研究和培训计划的特征，以及在临床实践中促进更好的医患沟通的实际障碍。
