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要成为一名出色的医生,你必须具备全面的素质:儿科医生在进行困难对话时的人际行为。

"To be a phenomenal doctor you have to be the whole package": physicians' interpersonal behaviors during difficult conversations in pediatrics.

机构信息

Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.

出版信息

J Palliat Med. 2013 Aug;16(8):929-33. doi: 10.1089/jpm.2013.0103. Epub 2013 Jun 28.

Abstract

BACKGROUND

Delivery of bad news is a challenging task for physicians and other health care professionals. Several studies have assessed parental perceptions of the delivery of bad news, but none have focused on the role of physicians' interpersonal behaviors in the communication process.

OBJECTIVE

The study's objective was to assess parental perceptions of physicians' interpersonal behaviors and their role in communication of bad news.

DESIGN

The design was a cross-sectional qualitative interview study of 13 parents of patients hospitalized or previously hospitalized in the pediatric intensive care unit or oncology/bone marrow transplant unit at an academic children's hospital.

RESULTS

Eleven interpersonal behaviors were identified as important by parents. The majority of parents identified empathy in physicians as critical. Availability, treating the child as an individual, and respecting the parent's knowledge of the child were mentioned by almost half of parents. Themes also considered important but by a smaller number of parents were allowing room for hope, the importance of body language, thoroughness, going beyond the call of duty, accountability, willingness to accept being questioned, and attention to the suffering of the child.

CONCLUSIONS

To increase parental satisfaction and enhance the parent-physician therapeutic partnership, we recommend that physicians consider attending to the 11 interpersonal behaviors described in this manuscript, and that educational programs pay particular attention to these behaviors when training health care providers in the communication of bad news.

摘要

背景

对于医生和其他医疗保健专业人员来说,传递坏消息是一项具有挑战性的任务。有几项研究评估了父母对传递坏消息的看法,但没有一项研究关注医生人际行为在沟通过程中的作用。

目的

本研究旨在评估父母对医生人际行为的看法及其在传递坏消息中的作用。

设计

这是一项在学术儿童医院的儿科重症监护病房或肿瘤/骨髓移植病房住院或曾住院的 13 名患儿家长的横断面定性访谈研究。

结果

父母确定了 11 种重要的人际行为。大多数父母认为医生的同理心至关重要。近一半的父母认为医生的可及性、将孩子视为个体以及尊重父母对孩子的了解很重要。还有一些主题也被认为很重要,但被较少的父母提及,包括为希望留出空间、重视肢体语言、彻底、超越职责范围、问责制、愿意接受质疑以及关注孩子的痛苦。

结论

为了提高父母的满意度并加强医患治疗伙伴关系,我们建议医生关注本文描述的 11 种人际行为,并且在培训医疗保健提供者传递坏消息时,教育项目特别关注这些行为。

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