De Vries A M M, de Roten Y, Meystre C, Passchier J, Despland J-N, Stiefel F
Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland; Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Psychooncology. 2014 Apr;23(4):375-81. doi: 10.1002/pon.3445. Epub 2013 Nov 14.
The aim of this study was to review the literature on clinician characteristics influencing patient-clinician communication or patient outcome in oncology.
Studies investigating the association of clinician characteristics with quality of communication and with outcome for adult cancer patients were systematically searched in MEDLINE, PSYINFO, PUBMED, EMBASE, CINHAL, Web of Science and The Cochrane Library up to November 2012. We used the preferred reporting items for systematic reviews and meta-analyses statement to guide our review. Articles were extracted independently by two of the authors using predefined criteria.
Twenty seven articles met the inclusion criteria. Clinician characteristics included a variety of sociodemographic, relational, and personal characteristics. A positive impact on quality of communication and/or patient outcome was reported for communication skills training, an external locus of control, empathy, a socioemotional approach, shared decision-making style, higher anxiety, and defensiveness. A negative impact was reported for increased level of fatigue and burnout and expression of worry. Professional experience of clinicians was not related to communication and/or to patient outcome, and divergent results were reported for clinician gender, age, stress, posture, and confidence or self-efficacy.
Various clinician characteristics have different effects on quality of communication and/or patient outcome. Research is needed to investigate the pathways leading to effective communication between clinicians and patients.
本研究旨在综述关于影响肿瘤学领域医患沟通或患者预后的临床医生特征的文献。
截至2012年11月，在MEDLINE、PSYINFO、PUBMED、EMBASE、CINHAL、科学引文索引和考克兰图书馆中系统检索了调查临床医生特征与成年癌症患者沟通质量及预后之间关联的研究。我们使用系统评价和荟萃分析的首选报告项目声明来指导我们的综述。文章由两位作者根据预定义标准独立提取。
27篇文章符合纳入标准。临床医生特征包括各种社会人口统计学、关系和个人特征。据报道，沟通技能培训、外控型人格、同理心、社会情感方法、共同决策风格、较高的焦虑水平和防御性对沟通质量和/或患者预后有积极影响。据报道，疲劳和倦怠程度增加以及担忧的表达有负面影响。临床医生的专业经验与沟通和/或患者预后无关，关于临床医生的性别、年龄、压力、姿势以及信心或自我效能的研究结果存在分歧。
各种临床医生特征对沟通质量和/或患者预后有不同影响。需要开展研究以探究临床医生与患者之间实现有效沟通的途径。
