Manchester Medical School, University of Manchester, Manchester, UK.
Br J Gen Pract. 2013 Apr;63(609):e283-90. doi: 10.3399/bjgp13X665251.
Good communication skills are integral to successful doctor-patient relationships. Communication may be verbal or non-verbal, and touch is a significant component, which has received little attention in the primary care literature. Touch may be procedural (part of a clinical task) or expressive (contact unrelated to a procedure/examination).
To explore GPs' and patients' experiences of using touch in consultations.
Qualitative study in urban and semi-rural areas of north-west England.
Participating GPs recruited registered patients with whom they felt they had an ongoing relationship. Data were collected by semi-structured interviews and subjected to constant comparative qualitative analysis.
All participants described the importance of verbal and non-verbal communication in developing relationships. Expressive touch was suggested to improve communication quality by most GPs and all patients. GPs reported a lower threshold for using touch with older patients or those who were bereaved, and with patients of the same sex as themselves. All patient responders felt touch on the hand or forearm was appropriate. GPs described limits to using touch, with some responders rarely using anything other than procedural touch. In contrast, most patient responders believed expressive touch was acceptable, especially in situations of distress. All GP responders feared misinterpretation in their use of touch, but patients were keen that these concerns should not prevent doctors using expressive touch in consultations.
Expressive touch improves interactions between GPs and patients. Increased educational emphasis on the conscious use of expressive touch would enhance clinical communication and, hence, perhaps patient wellbeing and care.
良好的沟通技巧是成功医患关系的重要组成部分。沟通可以是口头的或非口头的，而触摸是一个重要的组成部分，但在初级保健文献中却很少受到关注。触摸可能是程序性的（临床任务的一部分），也可能是表达性的（与程序/检查无关的接触）。
探索全科医生和患者在咨询中使用触摸的体验。
在英格兰西北部的城市和半农村地区进行定性研究。
参与的全科医生招募了他们认为与他们有持续关系的注册患者。通过半结构化访谈收集数据，并进行持续比较的定性分析。
所有参与者都描述了口头和非言语沟通在建立关系中的重要性。表达性触摸被大多数全科医生和所有患者认为可以提高沟通质量。全科医生报告说，他们更倾向于对老年患者或丧偶患者以及与自己性别相同的患者使用触摸。所有患者受访者都认为触摸手或前臂是合适的。全科医生描述了使用触摸的限制，一些回应者很少使用除程序性触摸以外的任何触摸。相比之下，大多数患者受访者认为表达性触摸是可以接受的，尤其是在痛苦的情况下。所有全科医生回应者都担心他们使用触摸会被误解，但患者希望医生在咨询中不要因为这些担忧而避免使用表达性触摸。
表达性触摸可以改善全科医生和患者之间的互动。在有意识地使用表达性触摸方面增加教育重点将增强临床沟通，从而提高患者的幸福感和护理水平。
