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改善以患者为中心的沟通:一项随机对照试验的结果

Improving patient-centered communication: Results of a randomized controlled trial.

作者信息

Maatouk-Bürmann Barbara, Ringel Nadja, Spang Jochen, Weiss Carmen, Möltner Andreas, Riemann Urs, Langewitz Wolf, Schultz Jobst-Hendrik, Jünger Jana

机构信息

Department of General Internal Medicine and Psychosomatic, Heidelberg University Hospital, Heidelberg, Germany.

Department of General Internal Medicine and Psychosomatic, Heidelberg University Hospital, Heidelberg, Germany.

出版信息

Patient Educ Couns. 2016 Jan;99(1):117-24. doi: 10.1016/j.pec.2015.08.012. Epub 2015 Aug 14.

Abstract

OBJECTIVE

Patient-centered communication is a key element for improving the quality of care in terms of therapeutic relationship, patient participation, and treatment process. Postgraduate trainings provide an essential way of promoting patient centeredness on the job where learning opportunities are often limited by time, patient volume, and economic pressure. In the present study, changes in patient centeredness during clinical routines of postgraduate physicians (internal medicine) after a three-day communication training were assessed.

METHODS

A randomized controlled trial was conducted in a primary care clinic. The intervention consisted of a communication training that aimed to enhance patient centeredness in postgraduate physicians. The training was based on a need assessment and the principles of deliberate practice. Workplace-based assessment of physicians' communication behavior was obtained using the Roter Interaction Analysis System.

RESULTS

Three months after the intervention, trained physicians showed significantly increased patient centeredness (F=5.36, p=.04; d=0.42).

CONCLUSION

The communication training significantly improved patient centeredness during routine clinical practice. Thus, this training provides a structured and theory-based concept to foster patient centeredness.

PRACTICE IMPLICATIONS

The results support the implementation of communication trainings as a part of faculty development and medical specialization training.

摘要

目的

以患者为中心的沟通是在治疗关系、患者参与度和治疗过程方面提高医疗质量的关键要素。研究生培训是在工作中促进以患者为中心的一种重要方式,而在工作中,学习机会常常受到时间、患者数量和经济压力的限制。在本研究中,评估了经过为期三天的沟通培训后,内科研究生医师临床日常工作中以患者为中心程度的变化。

方法

在一家基层医疗诊所进行了一项随机对照试验。干预措施包括旨在提高研究生医师以患者为中心程度的沟通培训。该培训基于需求评估和刻意练习的原则。使用罗特互动分析系统对医师的沟通行为进行基于工作场所的评估。

结果

干预三个月后,接受培训的医师以患者为中心的程度显著提高(F = 5.36,p = 0.04;d = 0.42)。

结论

沟通培训显著提高了日常临床实践中以患者为中心的程度。因此,该培训提供了一个结构化的、基于理论的概念来促进以患者为中心。

实践意义

研究结果支持将沟通培训作为教师发展和医学专业培训的一部分来实施。

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