Arborelius E, Timpka T
Department of Community Medicine, Faculty of Health Sciences, Linköping, Sweden.
Fam Pract. 1990 Jun;7(2):84-90. doi: 10.1093/fampra/7.2.84.
The aim of this study was to describe, understand and interpret physicians' experiences of consultations. Forty-six consultations were videotaped in four primary health care centres. Twelve general practitioners and 46 patients participated. Afterwards the patients and the physicians (on different occasions) commented on the recorded consultations. The comments were analysed from an inductive as well as a hypothetical-deductive model. The analyses agreed well with each other. The result demonstrated that the physicians often had difficulties understanding the patient, that they did not really know how to handle the conversation and felt that they did not really understand the context. The perceived relation to the patient was mainly related to the patients' ability to give adequate information. It is concluded that a key factor in communication is the difficulty which the physician has in understanding what the patient in fact wants-the failure to be on the same wavelength so that the message from the patient can be received.
本研究的目的是描述、理解并阐释医生的会诊经历。在四个初级卫生保健中心对46次会诊进行了录像。12名全科医生和46名患者参与其中。之后,患者和医生(在不同场合)对录制的会诊进行了评论。从归纳模型和假设演绎模型对评论进行了分析。两种分析结果彼此吻合。结果表明,医生常常难以理解患者,他们并不真正知道如何掌控谈话,并且觉得自己并未真正理解背景情况。感知到的与患者的关系主要与患者提供充分信息的能力有关。得出的结论是,沟通中的一个关键因素是医生难以理解患者实际上想要什么——未能达成共识,以至于无法接收来自患者的信息。