Martin O, Rockenbauch K, Kleinert E, Stöbel-Richter Y
Institut für medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle, Deutschland.
Abteilung für Medizinische Psychologie und Medizinische Soziologie, Department für Psychische Gesundheit, Universitätsklinikum Leipzig AöR, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
Nervenarzt. 2017 Sep;88(9):1026-1035. doi: 10.1007/s00115-016-0178-x.
Communication between physicians and patients has a great influence on patient adherence, patient satisfaction and the success of treatment. In this context, patient centered care and emotional support have a high positive impact; however, it is unclear how physicians can be motivated to communicate with patients in an appreciative and empathetic way. The implementation of such behavior requires a multitude of communicative skills. One of them is active listening, which is very important in two respects. On the one hand active listening provides the basis for several conversational contexts as a special communication technique and on the other hand active listening is presented in current textbooks in different ways: as an attitude or as a technique. In light of this, the question arises how active listening should be taught in order to be not only applicable in concrete conversations but also to lead to the highest possible level of patient satisfaction. The aim of this pilot study was to examine some variations in simulated doctor-patient conversations, which are the result of the different approaches to active listening. For this purpose three groups of first semester medical students were recruited, two of which were schooled in active listening in different ways (two groups of six students), i.e. attitude versus technique oriented. The third group (seven students) acted as the control group. In a pre-post design interviews with standardized simulation patients were conducted and subsequently evaluated. The analysis of these interviews was considered from the perspectives of participants and observers as well as the quantitative aspects. This study revealed some interesting tendencies despite its status as a pilot study: in general, the two interventional groups performed significantly better than the control group in which no relevant changes occurred. In a direct comparison, the group in which active listening was taught from an attitude approach achieved better results than the group in which the focus was on the technical aspects of active listening. In the group with active listening schooled as an attitude, the response to the feelings of the standardized simulation patients was significantly better from the perspectives of both participants and observers.
医生与患者之间的沟通对患者的依从性、满意度以及治疗的成功有着重大影响。在这种情况下，以患者为中心的护理和情感支持具有很高的积极影响；然而，尚不清楚如何激励医生以一种理解和共情的方式与患者沟通。这种行为的实施需要多种沟通技巧。其中之一是积极倾听，它在两个方面非常重要。一方面，积极倾听作为一种特殊的沟通技巧为多种对话情境提供了基础；另一方面，当前的教科书中对积极倾听的呈现方式各不相同：作为一种态度或一种技巧。鉴于此，就产生了一个问题，即应如何教授积极倾听，以便它不仅能应用于具体对话中，还能带来尽可能高的患者满意度。这项试点研究的目的是检验模拟医患对话中的一些差异，这些差异是不同的积极倾听方法所导致的结果。为此，招募了三组大一医学生，其中两组（每组六名学生）以不同方式接受积极倾听培训，即以态度导向和技巧导向。第三组（七名学生）作为对照组。采用前后测设计，对标准化模拟患者进行访谈并随后进行评估。从参与者、观察者以及定量方面的角度对这些访谈进行了分析。尽管这项研究是一项试点研究，但仍揭示了一些有趣的趋势：总体而言，两个干预组的表现明显优于未发生相关变化的对照组。在直接比较中，以态度方法教授积极倾听的组比专注于积极倾听技术方面的组取得了更好的结果。在以态度方式教授积极倾听的组中，从参与者和观察者的角度来看，对标准化模拟患者感受的回应都明显更好。
