Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA.
Patient Educ Couns. 2012 Nov;89(2):288-91. doi: 10.1016/j.pec.2012.07.017. Epub 2012 Sep 3.
More patient-centered communication is associated with improved patient satisfaction and health status, fewer malpractice complaints, and increased adherence. In a study of medical encounters for acute low back pain (LBP), we conducted a secondary analysis to assess the validity of the Patient Practitioner Orientation Scale (PPOS), a measure of patient-centeredness.
Fourteen clinicians and 89 of their patients with acute LBP completed the PPOS and agreed to have verbal exchanges recorded and coded using the Roter Interaction Analysis System (RIAS). We examined correlations between the PPOS and counts of patient and provider utterances within 8 RIAS verbal exchange categories.
Providers with a more patient-centered orientation asked fewer biomedical questions, posed more lifestyle questions, gave more lifestyle advice, and did more rapport-building. Their patients shared more lifestyle information and made more attempts at rapport building and provider engagement. In contrast, the patient-centered orientation of patients showed no effect on communication.
The PPOS scores of providers, but not patients, predicted significant and meaningful differences in the verbal exchanges of patients and providers.
The results support the validity of the PPOS measure and provide further evidence of the extent to which provider orientation influences patient communication and exchange.
更以患者为中心的沟通方式与改善患者满意度和健康状况、减少医疗事故投诉以及提高患者依从性有关。在一项针对急性腰痛（LBP）医疗接触的研究中，我们进行了二次分析，以评估患者医生取向量表（PPOS）的有效性，该量表用于衡量以患者为中心的程度。
14 名临床医生和 89 名患有急性 LBP 的患者完成了 PPOS，并同意记录口头交流并使用 Roter 互动分析系统（RIAS）进行编码。我们检查了 PPOS 与 8 个 RIAS 口头交流类别中的患者和提供者话语计数之间的相关性。
以患者为中心的医生提出的生物医学问题较少，提出的生活方式问题较多，提供的生活方式建议较多，并且建立融洽关系的能力更强。他们的患者分享了更多的生活方式信息，并更多地尝试建立融洽关系和与医生合作。相比之下，患者的以患者为中心的取向对沟通没有影响。
提供者的 PPOS 得分，而不是患者的 PPOS 得分，预测了患者和提供者的口头交流中显著且有意义的差异。
结果支持 PPOS 测量的有效性，并进一步证明了医生取向对患者沟通和交流的影响程度。
