Kaplan S H, Greenfield S, Ware J E
Institute for the Improvement of Medical Care and Health, New England Medical Center, Boston, MA 02111.
Med Care. 1989 Mar;27(3 Suppl):S110-27. doi: 10.1097/00005650-198903001-00010.
Growing interest in the doctor-patient relationship focuses attention on the specific elements of that relationship that affect patients' health outcomes. Data are presented for four clinical trials conducted in varied practice settings among chronically ill patients differing markedly in sociodemographic characteristics. These trials demonstrated that "better health" measured physiologically (blood pressure or blood sugar), behaviorally (functional status), or more subjectively (evaluations of overall health status) was consistently related to specific aspects of physician-patient communication. We conclude that the physician-patient relationship may be an important influence on patients' health outcomes and must be taken into account in light of current changes in the health care delivery system that may place this relationship at risk.
对医患关系日益增长的兴趣将注意力集中在该关系中影响患者健康结果的具体因素上。文中呈现了在不同实践环境中针对社会人口统计学特征差异显著的慢性病患者进行的四项临床试验的数据。这些试验表明，通过生理指标（血压或血糖）、行为指标（功能状态）或更主观的指标（整体健康状况评估）衡量的“更好的健康状况”与医患沟通的特定方面始终相关。我们得出结论，医患关系可能对患者的健康结果产生重要影响，鉴于医疗保健提供系统当前的变化可能使这种关系面临风险，必须对此加以考虑。
