Department of Communication, Texas A&M University, College Station, TX, United States; Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Houston VA Center for Innovations in Quality, Effectiveness and Safety, United States.
Patient Educ Couns. 2017 Nov;100(11):2131-2134. doi: 10.1016/j.pec.2017.05.008. Epub 2017 May 5.
To critically examine different approaches to the measurement of patient-centered communication.
Provides a critique of 7 different measures of patient-centered communication with respect to differences in their assumptions about what constitutes patient-centeredness and in their approaches to measurement.
The measures differed significantly with regard to whether the measure captured behavior (what the interactants did) or judgment (how well the behavior was performed), focused on the individual clinician or on the interaction as a whole, and on who makes the assessment (participant or observer). A multidimensional framework for developing patient-centered communication measures is presented that encompasses the patient's perspective and participation, the biopsychosocial context of the patient's health, the clinician-patient relationship, quality of information-exchange, shared understanding, and shared, evidence-based decision-making.
The state of measurement of the patient-centered communication construct lacks coherence, in part because current measures were developed either void of a conceptual framework or from very different theoretical perspectives.
Assessment of patients' experiences with quality of communication in medical encounters should drill down into specific domains of patient-centeredness.
批判性地考察用于测量以患者为中心的沟通的不同方法。
提供了对 7 种不同的以患者为中心的沟通测量方法的评价，涉及到它们对以患者为中心的构成的假设差异，以及它们在测量方法上的差异。
这些措施在测量的行为（互动者的行为）或判断（行为表现的好坏）、关注个体临床医生还是整个互动、以及谁进行评估（参与者还是观察者）方面存在显著差异。提出了一个多维框架来开发以患者为中心的沟通测量方法，该框架包含患者的视角和参与、患者健康的生物心理社会背景、医患关系、信息交换的质量、共同理解以及共同的、基于证据的决策制定。
以患者为中心的沟通结构的测量状态缺乏一致性，部分原因是当前的测量方法要么缺乏概念框架，要么来自非常不同的理论视角。
评估患者在医疗接触中对沟通质量的体验应该深入到以患者为中心的特定领域。
