Alders Irèn, Smits Carolien, Brand Paul, van Dulmen Sandra
Dept. of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; Research Group Innovation with Older Adults, Windesheim, University of Applied Sciences, Zwolle, the Netherlands.
Research Group Innovation with Older Adults, Windesheim, University of Applied Sciences, Zwolle, the Netherlands.
Patient Educ Couns. 2017 May;100(5):882-896. doi: 10.1016/j.pec.2016.12.029. Epub 2016 Dec 29.
To systematically review the literature on the effectiveness of a patient coach intervention on patient - physician communication in specialists consultations.
PubMed, Cochrane, PsycInfo, Cinahl and Embase were searched until November 2015. Included were papers describing interventions directed at adult outpatients in secondary care with a variety of somatic diseases. Outcomes had to be measured in communication effectivity from a patient's perspective.
Seventeen publications met the inclusion criteria (involving 3787 patients), describing 13 unique interventions. Most interventions were single one-on-one sessions taking between 20 and 40min before consultation. Research quality in ten studies was high. These studies showed significant improvement on immediate, intermediate and long term patient - physician communication.
We found limited evidence suggesting an improvement of patient - physician communication by having multiple patient coaching encounters during which questions are prepared and rehearsed and consultations are evaluated and reflected upon, sometimes supported by audio recording the consultation.
The results of this review contribute to the (re-)design of an effective model for patient coaching, a profile and training approach of patient coaches. Future research should aim at determining which patients will benefit most from coaching interventions.
系统回顾关于患者指导干预对专科门诊中患者与医生沟通效果的文献。
检索至2015年11月的PubMed、Cochrane、PsycInfo、Cinahl和Embase数据库。纳入的文献描述了针对患有各种躯体疾病的二级护理成年门诊患者的干预措施。结局必须从患者角度衡量沟通有效性。
17篇出版物符合纳入标准（涉及3787名患者），描述了13种独特的干预措施。大多数干预措施是在会诊前进行的时长20至40分钟的一对一单次 sessions。十项研究的研究质量较高。这些研究表明患者与医生的沟通在即时、中期和长期均有显著改善。
我们发现有限的证据表明，通过多次进行患者指导，在此过程中准备并演练问题、评估并反思会诊，有时辅以会诊录音，可改善患者与医生的沟通。
本综述结果有助于（重新）设计有效的患者指导模式、患者指导者的概况及培训方法。未来研究应旨在确定哪些患者将从指导干预中获益最大。
