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临床医生的个性及其人际行为对患者护理质量的影响:一项系统综述。

The impact of clinicians' personality and their interpersonal behaviors on the quality of patient care: a systematic review.

作者信息

Boerebach Benjamin C M, Scheepers Renée A, van der Leeuw Renée M, Heineman Maas Jan, Arah Onyebuchi A, Lombarts Kiki M J M H

机构信息

Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Center for Evidence-Based Education, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Board of Directors, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Int J Qual Health Care. 2014 Aug;26(4):426-81. doi: 10.1093/intqhc/mzu055. Epub 2014 May 20.

Abstract

PURPOSE

To review systematically the impact of clinicians' personality and observed interpersonal behaviors on the quality of their patient care.

DATA SOURCES

We searched MEDLINE, EMBASE and PsycINFO from inception through January 2014, using both free text words and subject headings, without language restriction. Additional hand-searching was performed.

STUDY SELECTION

The PRISMA framework guided (the reporting of) study selection and data extraction. Eligible articles were selected by title, abstract and full text review subsequently.

DATA EXTRACTION

Data on study setting, participants, personality traits or interpersonal behaviors, outcome measures and limitations were extracted in a systematic way.

RESULTS OF DATA SYNTHESIS

Our systematic search yielded 10 476 unique hits. Ultimately, 85 studies met all inclusion criteria, 4 on clinicians' personality and 81 on their interpersonal behaviors. The studies on interpersonal behaviors reported instrumental (n = 45) and affective (n = 59) verbal behaviors or nonverbal behaviors (n = 20). Outcome measures in the studies were quality of processes of care (n = 68) and patient health outcomes (n = 35). The above categories were non-exclusive. The majority of the studies found little or no effect of clinicians' personality traits and their interpersonal behaviors on the quality of patient care. The few studies that found an effect were mostly observational studies that did not address possible uncontrolled confounding.

CONCLUSIONS

There is no strong empirical evidence that specific interpersonal behaviors will lead to enhanced quality of care. These findings could imply that clinicians can adapt their interactions toward patients' needs and preferences instead of displaying certain specific behaviors per se.

摘要

目的

系统回顾临床医生的个性及观察到的人际行为对其患者护理质量的影响。

数据来源

我们检索了自数据库建立至2014年1月的MEDLINE、EMBASE和PsycINFO数据库,使用自由文本词和主题词,无语言限制。还进行了额外的手工检索。

研究选择

PRISMA框架指导研究选择和数据提取的报告。随后通过标题、摘要和全文审查筛选符合条件的文章。

数据提取

以系统的方式提取有关研究背景、参与者、个性特征或人际行为、结局指标和局限性的数据。

数据综合结果

我们的系统检索产生了10476条独特记录。最终,85项研究符合所有纳入标准,4项关于临床医生的个性,81项关于他们的人际行为。关于人际行为的研究报告了工具性(n = 45)和情感性(n = 59)言语行为或非言语行为(n = 20)。这些研究中的结局指标是护理过程质量(n = 68)和患者健康结局(n = 35)。上述类别并非相互排斥。大多数研究发现临床医生的个性特征及其人际行为对患者护理质量几乎没有或没有影响。少数发现有影响的研究大多是观察性研究,未解决可能存在的未控制混杂因素。

结论

没有强有力的实证证据表明特定的人际行为会提高护理质量。这些发现可能意味着临床医生可以根据患者的需求和偏好调整互动方式,而不是本身展示某些特定行为。

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