Allen Emily-Charlotte Frances, Arroll Bruce
Department of General Practice and Primary Health Care, University of Auckland, New Zealand.
Director of the Goodfellow Unit, Department of General Practice and Primary Health Care, University of Auckland, New Zealand.
Br J Gen Pract. 2015 Sep;65(638):e601-8. doi: 10.3399/bjgp15X686521.
There is a debate in medicine about the use and value of self-disclosure by the physician as a communication tool. There is little empirical evidence about GPs and self-disclosure.
To explore what GPs' attitudes, skills, and behaviour are with regard to self-disclosure during a clinical consultation and whether there is a need for the development of training resources.
Mixed methods using open-ended and semi-structured interviews in Auckland, New Zealand, and the surrounding districts.
Sixteen GPs were interviewed on the issue of self-disclosure in clinical practice. A general inductive approach was used for data analysis.
Self-disclosure was common in this group of GPs, contrary to training in some of the groups, and was seen as a potentially positive activity. Family and physical topics were most common, yet psychological and relationship issues were also discussed. Knowing patients made self-disclosure more likely, but a GP's intuition played the main role in determining when to self-disclose, and to whom. GPs have developed their own guidelines, shaped by years of experience; however, there was a consensus that training would be helpful.
Self-disclosure is common and, in general, seen as positive. Major personal issues were acceptable for some GPs to self-disclose, especially to known patients. Although participants had developed their own guidelines, exposure of trainees to the issue of self-disclosure would be of value to prevent future mistakes and to protect both doctor and patient from any unintended harm, for example, developing a dependent relationship.
在医学领域，关于医生自我表露作为一种沟通工具的使用和价值存在争议。关于全科医生与自我表露的实证证据很少。
探讨全科医生在临床会诊中对自我表露的态度、技能和行为，以及是否需要开发培训资源。
采用开放式和半结构式访谈的混合方法，在新西兰奥克兰及周边地区进行。
就临床实践中的自我表露问题对16名全科医生进行了访谈。数据分析采用一般归纳法。
与部分群体的培训情况相反，自我表露在这群全科医生中很常见，且被视为一种潜在的积极行为。家庭和身体方面的话题最为常见，但心理和人际关系问题也会被讨论。了解患者会使自我表露更有可能发生，但全科医生的直觉在决定何时以及向谁进行自我表露时起主要作用。全科医生根据多年经验制定了自己的指导原则；然而，大家一致认为培训将有所帮助。
自我表露很常见，总体上被视为积极的。一些全科医生认为可以自我表露重大个人问题，尤其是对熟悉的患者。尽管参与者已经制定了自己的指导原则，但让实习医生接触自我表露问题将有助于防止未来出现错误，并保护医生和患者免受任何意外伤害，例如建立依赖关系。
