Cancer Control and Population Sciences, Duke Cancer Institute, USA; Department of Community and Family Medicine, Duke University, USA.
Department of Medicine, University of Washington and Fred Hutchinson Cancer Research Center, USA.
Patient Educ Couns. 2017 Oct;100(10):1951-1954. doi: 10.1016/j.pec.2017.05.015. Epub 2017 May 9.
Patient-clinician communication that promotes patient engagement enhances health care quality. Yet, disseminating effective communication interventions to practicing clinicians remains challenging. Current methods do not have large and sustainable effects. In this paper, we argue that both top-down approaches (mandated by institutions) should be coupled with bottom-up approaches that address clinician motivation, confidence, and barriers. We need to engage clinicians in the same way we ask them to engage patients - strategically and with empathy. We discuss potentially innovative strategies to integrate top-down and bottom-up approaches in ways that fit clinicians' busy schedules and can inform policy.
促进患者参与的医患沟通可提高医疗质量。然而，将有效的沟通干预措施推广给执业临床医生仍然具有挑战性。目前的方法没有产生大而持久的效果。在本文中，我们认为，应该将自上而下的方法（由机构强制实施）与自下而上的方法相结合，以解决临床医生的动机、信心和障碍问题。我们需要以与要求他们与患者互动相同的方式来让临床医生参与进来——要有策略、有同理心。我们讨论了一些潜在的创新策略，以将自上而下和自下而上的方法相结合，使其适应临床医生繁忙的日程安排，并为政策提供信息。
