Woolliscroft J O, Calhoun J G, Billiu G A, Stross J K, MacDonald M, Templeton B
Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0368.
J Gen Intern Med. 1989 Mar-Apr;4(2):108-14. doi: 10.1007/BF02602349.
The relationships among physicians' interviewing techniques, the amount and type of data gathered, and patients' perceptions of the interviewing process were studied. Thirty-one Internal Medicine house officers each interviewed one of three standardized patients. The house officers' thoroughness of data collection was assessed by the patients and by a trained evaluator. A videotape of each interview was analyzed at the National Board of Medical Examiners using the interaction analysis system for interview evaluation, ISIE-81, to define house officers' interviewing techniques. From the physicians' problem-solving perspective, data elicitation was positively related to the length of the interview, asking psychosocial questions, the use of narrow questions, and the amount of time the patient talked. The patients' assessments of house officers' data-gathering thoroughness were also positively influenced by interview length, the use of narrow questions, and inquiries about their psychosocial histories. The use of broad questions by the house officer was positively related to the patient's feelings about and reaction to the interaction. This study potentially explains some of the differences that appear to exist between patients' and physicians' judgments about and perceptions of the medical interviewing process.
研究了医生的问诊技巧、收集的数据量和类型以及患者对问诊过程的看法之间的关系。31名内科住院医师分别对三名标准化患者之一进行了问诊。患者和一名经过培训的评估人员对住院医师收集数据的彻底程度进行了评估。在国家医学考试委员会，使用用于面试评估的互动分析系统ISIE - 81对每次问诊的录像进行分析，以确定住院医师的问诊技巧。从医生解决问题的角度来看，数据引出与问诊时长、询问心理社会问题、使用封闭式问题以及患者交谈的时间量呈正相关。住院医师问诊时长、使用封闭式问题以及询问患者心理社会病史也对患者对住院医师收集数据彻底程度的评估产生了积极影响。住院医师使用开放式问题与患者对互动的感受和反应呈正相关。这项研究可能解释了患者和医生在对医疗问诊过程的判断和看法上似乎存在的一些差异。
