Little Paul, White Peter, Kelly Joanne, Everitt Hazel, Mercer Stewart
Primary Medical Care Group, Community Clinical Sciences Division, Faculty of Medicine, University of Southampton, Southampton.
Nightingale Surgery, Romsey.
Br J Gen Pract. 2015 Jun;65(635):e351-6. doi: 10.3399/bjgp15X685237.
The impact of changing non-verbal consultation behaviours is unknown.
To assess brief physician training on improving predominantly non-verbal communication.
Cluster randomised parallel group trial among adults aged ≥16 years attending general practices close to the study coordinating centres in Southampton.
Sixteen GPs were randomised to no training, or training consisting of a brief presentation of behaviours identified from a prior study (acronym KEPe Warm: demonstrating Knowledge of the patient; Encouraging [back-channelling by saying 'hmm', for example]; Physically engaging [touch, gestures, slight lean]; Warm-up: cool/professional initially, warming up, avoiding distancing or non-verbal cut-offs at the end of the consultation); and encouragement to reflect on videos of their consultation. Outcomes were the Medical Interview Satisfaction Scale (MISS) mean item score (1-7) and patients' perceptions of other domains of communication.
Intervention participants scored higher MISS overall (0.23, 95% confidence interval [CI] = 0.06 to 0.41), with the largest changes in the distress-relief and perceived relationship subscales. Significant improvement occurred in perceived communication/partnership (0.29, 95% CI = 0.09 to 0.49) and health promotion (0.26, 95% CI = 0.05 to 0.46). Non-significant improvements occurred in perceptions of a personal relationship, a positive approach, and understanding the effects of the illness on life.
Brief training of GPs in predominantly non-verbal communication in the consultation and reflection on consultation videotapes improves patients' perceptions of satisfaction, distress, a partnership approach, and health promotion.
非言语咨询行为变化的影响尚不清楚。
评估简短的医生培训对主要改善非言语沟通的作用。
在南安普敦研究协调中心附近的全科诊所中，对年龄≥16岁的成年人进行整群随机平行组试验。
16名全科医生被随机分为不接受培训组，或接受由先前研究确定的行为简短介绍组成的培训组（首字母缩写KEPe Warm：展示对患者的了解；鼓励[例如通过说“嗯”进行反馈交流]；身体互动[触摸、手势、轻微前倾]；热身：最初冷静/专业，逐渐热情起来，在咨询结束时避免疏远或非言语中断）；并鼓励他们反思自己咨询的视频。结果指标为医学访谈满意度量表（MISS）平均项目得分（1 - 7分）以及患者对其他沟通领域的看法。
干预组参与者的MISS总体得分更高（0.23，95%置信区间[CI] = 0.06至0.41），其中缓解痛苦和感知关系子量表的变化最大。在感知沟通/伙伴关系（0.29，95% CI = 0.09至0.49）和健康促进（0.26，95% CI = 0.05至0.46）方面有显著改善。在个人关系、积极态度以及对疾病对生活影响的理解等方面的感知有非显著改善。
对全科医生进行简短的主要针对咨询中非言语沟通的培训以及对咨询录像进行反思，可提高患者对满意度、痛苦程度、伙伴关系方法和健康促进的感知。
