JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 4/F, School of Public Health building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR.
BMC Fam Pract. 2013 Dec 24;14:200. doi: 10.1186/1471-2296-14-200.
There is limited evidence to support the use of facemasks in preventing infection for primary care professionals. Negative effects on communication has been suggested when the physician wears a facemask. As communication skills and doctor patient relationship are essential to primary care consultations, the effects of doctor's facemask wearing were explored.
A randomised controlled study was conducted in primary care to explore the effects of doctors wearing facemasks on patients' perception of doctors' empathy, patient enablement and patient satisfaction. Primary care doctors were randomized to mask wearing and non mask wearing clinical consultations in public primary care clinics in Hong Kong. Patients' views were gathered using the Consultation and Relational Empathy (CARE) Measure, Patient Enablement Instrument (PEI) and an overall satisfaction rating scale. The effects of face mask wearing were investigated using multilevel (hierarchical) modelling.
1,030 patients were randomised to doctor-mask wearing consultations (n = 514) and non mask wearing consultations (n = 516). A significant and negative effect was found in the patients' perception of the doctors' empathy (CARE score reduction -0.98, p-value = 0.04). In the more established doctor-patient relationship, the effect of doctors' mask wearing was more pronounced (CARE score reduction -5.67, p-value = 0.03).
This study demonstrates that when doctors wearing a facemask during consultations, this has a significant negative impact on the patient's perceived empathy and diminish the positive effects of relational continuity. Consideration should be taken in planning appropriate use of facemasks in infectious disease policy for primary care and other healthcare professionals at a national, local or practice level.
This trial was registered on Chinese Clinical Trial Register (ChiCTR). Registration no.: ChiCTR-TTRCC-12002519. URL: http://www.chictr.org/en/proj/show.aspx?proj=3486. Due to administrative error, registration of trial did not take place until after the trial started on 1st August 2011 and registration number was released on 21st September 2012.
有限的证据支持在初级保健中使用口罩来预防感染。当医生戴口罩时，已经有人建议这会对沟通产生负面影响。由于沟通技巧和医患关系对初级保健咨询至关重要，因此探讨了医生戴口罩的影响。
在香港的基层医疗诊所进行了一项随机对照研究，以探讨医生戴口罩对患者对医生同理心、患者赋权和患者满意度的感知的影响。初级保健医生被随机分配到戴口罩和不戴口罩的临床咨询中，在香港的公共基层医疗诊所进行。使用咨询和关系同理心 (CARE) 量表、患者赋权工具 (PEI) 和整体满意度评分量表收集患者的意见。使用多层次 (分层) 模型研究了口罩佩戴的效果。
共有 1030 名患者被随机分配到医生戴口罩的咨询（n = 514）和不戴口罩的咨询（n = 516）。发现患者对医生同理心的感知有显著且负面的影响（CARE 评分降低-0.98，p 值 = 0.04）。在更成熟的医患关系中，医生戴口罩的影响更为明显（CARE 评分降低-5.67，p 值 = 0.03）。
这项研究表明，当医生在咨询时戴口罩时，这会对患者的同理心感知产生显著的负面影响，并削弱关系连续性的积极影响。在制定针对初级保健和其他医疗保健专业人员的传染病政策中，应考虑在国家、地方或实践层面适当使用口罩。
该试验在中国临床试验注册中心（ChiCTR）注册。注册号：ChiCTR-TTRCC-12002519。网址：http://www.chictr.org/en/proj/show.aspx？proj=3486。由于行政错误，试验注册直到 2011 年 8 月 1 日试验开始后才进行，注册号码于 2012 年 9 月 21 日发布。
