Hashim M Jawad
United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi, United Arab Emirates.
Am Fam Physician. 2017 Jan 1;95(1):29-34.
Communication skills needed for patient-centered care include eliciting the patient's agenda with open-ended questions, especially early on; not interrupting the patient; and engaging in focused active listening. Understanding the patient's perspective of the illness and expressing empathy are key features of patient-centered communication. Understanding the patient's perspective entails exploring the patient's feelings, ideas, concerns, and experience regarding the impact of the illness, as well as what the patient expects from the physician. Empathy can be expressed by naming the feeling; communicating understanding, respect, and support; and exploring the patient's illness experience and emotions. Before revealing a new diagnosis, the patient's prior knowledge and preferences for the depth of information desired should be assessed. After disclosing a diagnosis, physicians should explore the patient's emotional response. Shared decision making empowers patients by inviting them to consider the pros and cons of different treatment options, including no treatment. Instead of overwhelming the patient with medical information, small chunks of data should be provided using repeated cycles of the "ask-tell-ask" approach. Training programs on patient-centered communication for health care professionals can improve communication skills.
通过开放式问题引出患者的议程，尤其是在早期；不打断患者；进行专注的积极倾听。理解患者对疾病的看法并表达同理心是以患者为中心的沟通的关键特征。理解患者的观点需要探索患者对疾病影响的感受、想法、担忧和经历，以及患者对医生的期望。同理心可以通过说出感受、传达理解、尊重和支持，以及探索患者的疾病经历和情感来表达。在揭示新诊断之前，应评估患者的先验知识和对所需信息深度的偏好。在披露诊断后，医生应探索患者的情绪反应。共同决策通过邀请患者考虑不同治疗方案（包括不治疗）的利弊来赋予患者权力。不应向患者灌输过多医疗信息，而应使用“询问-告知-询问”方法的重复循环提供少量数据。针对医疗保健专业人员的以患者为中心的沟通培训计划可以提高沟通技巧。
