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住院医师与患者沟通的态度和信心:日本一所大学医院的一项试点研究。

Resident physicians' attitudes and confidence in communicating with patients: a pilot study at a Japanese university hospital.

作者信息

Ishikawa Hirono, Eto Masato, Kitamura Kiyoshi, Kiuchi Takahiro

机构信息

Department of Health Communication, The University of Tokyo, Tokyo, Japan.

General Education Center, University of Tokyo Hospital, Tokyo, Japan.

出版信息

Patient Educ Couns. 2014 Sep;96(3):361-6. doi: 10.1016/j.pec.2014.05.012. Epub 2014 May 23.

DOI:10.1016/j.pec.2014.05.012
PMID:24912746
Abstract

OBJECTIVE

This study aimed to explore the relationships among physicians' confidence in conducting medical interviews, their attitudes toward the patient-physician relationship, and undergraduate training in communication skills among resident physicians in Japan.

METHODS

Participants were 63 first-year resident physicians at a university hospital in Tokyo. The Physician Confidence in the Medical Interview scale (PCMI) was constructed based on the framework of the Calgary-Cambridge Guide. Additionally, participants' attitudes toward the patient-physician relationship (Patient-Practitioner Orientation Scale; PPOS), undergraduate experience of communication skills training, and demographic characteristics were assessed through a self-reported questionnaire.

RESULTS

The internal consistency of the PCMI and PPOS scales were adequate. As expected from the undergraduate curriculum for medical interviews in Japan, residents had relatively higher confidence in their communication skills with respect to gathering information and building the relationship, whereas less confident about sharing information and planning treatment. The PCMI was associated with a more patient-centered attitude as measured by the PPOS.

CONCLUSION

These scales could be useful tools to measure physicians' confidence and attitudes in communicating with patients and to explore their changes through medical education.

PRACTICE IMPLICATIONS

Residency programs should consider including systematic training and assessment in communication skills related to sharing information and planning treatment.

摘要

目的

本研究旨在探讨日本住院医师在进行医学访谈时的信心、他们对医患关系的态度以及本科阶段沟通技巧培训之间的关系。

方法

参与者为东京一家大学医院的63名一年级住院医师。基于卡尔加里-剑桥指南的框架构建了医学访谈中医师信心量表(PCMI)。此外,通过一份自填问卷评估了参与者对医患关系的态度(患者-从业者导向量表;PPOS)、本科阶段沟通技巧培训经历以及人口统计学特征。

结果

PCMI和PPOS量表的内部一致性良好。正如日本医学访谈本科课程所预期的那样,住院医师在收集信息和建立关系方面对自己的沟通技巧信心相对较高,而在分享信息和制定治疗计划方面信心较低。通过PPOS测量,PCMI与更以患者为中心的态度相关。

结论

这些量表可能是衡量医生与患者沟通时的信心和态度以及通过医学教育探索其变化的有用工具。

实践意义

住院医师培训项目应考虑纳入与分享信息和制定治疗计划相关的沟通技巧的系统培训和评估。

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