Hemanth Kumar V R, Jahagirdar Sameer Mahamud, Ravishankar M, Athiraman Umesh Kumar, Maclean Jennyl, Parthasarathy S
Department of Anaesthesiology and Critical Care, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, Tamil Nadu, India.
Department of Anesthesiology, Washington University, St. Louis, Missouri 63110, USA.
Anesth Essays Res. 2016 May-Aug;10(2):223-6. doi: 10.4103/0259-1162.167848.
We conducted an audit of various communication practices during perioperative care among anesthesiology resident (R), faculties (F), and private practitioners (PP) in South India. We also documented the level of psycho-social support given to the patient and patient relatives and communication with the surgical colleagues during perioperative care.
A 15-point questionnaire based on communication practices was distributed in three major anesthesiology conferences requesting anesthesiologists to answer and drop the forms in the drop box provided. Resident and consultant level anesthesiologists of various Medical Schools in South India and private practitioners were involved in the study. The answers were analyzed to find out the various communication practices in perioperative care.
The freelancing private practitioners (PP) were more communicative to patient and relatives especially in complicated cases (Q1 - 45.6%, Q2 - 97.8%, Q4 - 94.4%, Q8 - 98.9%, respectively) in comparison with institutionalized practitioners. The choice of anesthesia and discussion related to the advantages of one mode of anesthesia over other was the most neglected part of communication (R - 14.2%, F - 17.6%, and PP - 5.6%). The PP's (95.6%) are more concerned about intraoperative communication (R - 27.6%, F - 39.2%). The discussion of postoperative pain management plan with the surgeon is not given priority in the communication by postgraduates (7.9%) and teaching faculties (8.8%).
There is an urgent need to introspect and change the communication practices. We strongly recommend that communications skills should be introduced in anesthesiology resident curriculum.
我们对印度南部麻醉科住院医师（R）、教员（F）和私人执业医生（PP）围手术期护理期间的各种沟通实践进行了一项审计。我们还记录了围手术期护理期间给予患者及其亲属的心理社会支持水平以及与外科同事的沟通情况。
基于沟通实践的一份15项问卷在三场主要的麻醉学会议上分发，要求麻醉医生作答并将表格放入提供的投递箱。印度南部各医学院的住院医师和顾问级麻醉医生以及私人执业医生参与了该研究。对答案进行分析以找出围手术期护理中的各种沟通实践。
与机构化执业医生相比，自由职业的私人执业医生（PP）与患者及其亲属的沟通更多，尤其是在复杂病例中（问题1 - 45.6%，问题2 - 97.8%，问题4 - 94.4%，问题8 - 98.9%）。麻醉方式的选择以及关于一种麻醉方式优于另一种麻醉方式的优势的讨论是沟通中最被忽视的部分（住院医师 - 14.2%，教员 - 17.6%，私人执业医生 - 5.6%）。私人执业医生（95.6%）更关注术中沟通（住院医师 - 27.6%，教员 - 39.2%）。研究生（7.9%）和教师（8.8%）在沟通中没有优先考虑与外科医生讨论术后疼痛管理计划。
迫切需要反思并改变沟通实践。我们强烈建议在麻醉科住院医师课程中引入沟通技巧。
