Arroll Bruce, Allen Emily-Charlotte Frances
Director of the Goodfellow Unit, Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand;
Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand.
Br J Gen Pract. 2015 Sep;65(638):e609-16. doi: 10.3399/bjgp15X686533.
There is a debate in medicine about the value of self-disclosure by the physician as a communication tool.
To review the empirical literature of self-disclosure in primary care.
Systematic review of empirical literature relating to self-disclosure by primary care physicians (including US paediatricians) from seven electronic databases (MEDLINE(®), Scopus, PsycINFO, Embase, Social Sciences Citation Index, EBSCOhost, and Cochrane Central Register of Controlled Trials [CENTRAL]).
Databases were searched for empirical studies on self-disclosure and primary care published from 1946 to 28 November 2014, as well as references from primary studies. The search was extended to include working papers, theses, and dissertations.
Nine studies were identified, with response rates ranging from 34% to 100%, as well as several not reported. Self-disclosure occurred in 14-75% of consultations, the most from paediatricians. Self-disclosure had intended benefit; however, one standardised patient study found that 85% of self-disclosures were not useful as reported by the transcript coders. Conflicting data emerged on the self-disclosure outcome.
This is the first systematic review of self-disclosure in primary care and medicine. Self-disclosure appears to be common and has the potential to be helpful when used judiciously. Few studies examined the impact on patients, and no studies considered the individual patient perspective nor the content which results in benefit or harm. No evidence was found of any training into how to deal with self-disclosure.
在医学领域，关于医生自我表露作为一种沟通工具的价值存在争议。
回顾基层医疗中自我表露的实证文献。
对来自七个电子数据库（MEDLINE®、Scopus、PsycINFO、Embase、社会科学引文索引、EBSCOhost和Cochrane对照试验中心注册库[CENTRAL]）的有关基层医疗医生（包括美国儿科医生）自我表露的实证文献进行系统回顾。
检索数据库，查找1946年至2014年11月28日发表的关于自我表露与基层医疗的实证研究以及原始研究的参考文献。检索范围扩大至工作论文、学位论文和学术论文。
共识别出九项研究，回复率从34%至100%不等，还有几项未报告回复率。自我表露出现在14%至75%的诊疗过程中，儿科医生的自我表露最为常见。自我表露有预期的益处；然而，一项标准化患者研究发现，根据文字记录编码员的报告，85%的自我表露并无用处。关于自我表露的结果出现了相互矛盾的数据。
这是首次对基层医疗和医学领域的自我表露进行系统回顾。自我表露似乎很常见，谨慎使用时可能会有帮助。很少有研究考察其对患者的影响，没有研究考虑个体患者的观点，也没有研究考虑会带来益处或伤害的内容。未发现有关于如何处理自我表露的培训的证据。
