Schoenthaler Antoinette, Kalet Adina, Nicholson Joseph, Lipkin Mack
Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, USA.
Section of Primary Care, Division of General Internal Medicine, Department of Medicine, NYU School of Medicine, New York, USA.
Patient Educ Couns. 2014 Jul;96(1):3-12. doi: 10.1016/j.pec.2014.04.006. Epub 2014 Apr 21.
To conduct a systematic literature review appraising the effects of interventions to improve patient-practitioner communication on cardiovascular-related clinical outcomes.
Databases were searched up to March 27, 2013 to identify eligible studies that included interventions to improve patient and/or practitioner communication skills and assessment of a cardiovascular-related clinical outcome in adults ≥18 years of age.
Fifteen papers were reviewed: the primary focus in seven studies was the patient; seven included a practitioner-focused intervention and one targeted both. Two patient-focused and two practitioner-focused studies demonstrated a beneficial effect of the intervention compared to a control group. Patient-focused studies were designed to improve patients' information-seeking and question-asking skills with their practitioner. Practitioner-focused studies were designed to either improve practitioner's general patient-centered communication or risk communication skills.
Few interventions targeting patient-practitioner communication have assessed the impact on cardiovascular-related clinical outcomes, limiting the ability to determine effectiveness. Additional rigorous research supported by theoretical frameworks and validated measurement is needed to understand the potential of patient-practitioner communication to improve cardiovascular-related clinical outcomes.
Investments in communication skills trainings in medical education and practice are needed in order to attain the full potential of patient-centered care on cardiovascular-related clinical outcomes.
进行一项系统的文献综述，评估改善医患沟通的干预措施对心血管相关临床结局的影响。
检索截至2013年3月27日的数据库，以确定符合条件的研究，这些研究包括改善患者和/或医生沟通技巧的干预措施，以及对18岁及以上成年人心血管相关临床结局的评估。
共审查了15篇论文：7项研究主要关注患者；7项研究包括以医生为重点的干预措施，1项研究同时针对两者。与对照组相比，两项以患者为重点的研究和两项以医生为重点的研究显示了干预措施的有益效果。以患者为重点的研究旨在提高患者向医生寻求信息和提问的技巧。以医生为重点的研究旨在提高医生以患者为中心的一般沟通能力或风险沟通能力。
很少有针对医患沟通的干预措施评估其对心血管相关临床结局的影响，这限制了确定有效性的能力。需要有理论框架支持的额外严格研究和经过验证的测量方法，以了解医患沟通改善心血管相关临床结局的潜力。
为了充分发挥以患者为中心的护理对心血管相关临床结局的潜力，需要在医学教育和实践中对沟通技巧培训进行投资。
