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全科医疗中的同理心——愿望与现实之间的差距:比较患者与医生的观点

Empathy in general practice-the gap between wishes and reality: comparing the views of patients and physicians.

作者信息

Derksen F A W M, Olde Hartman Tim, Bensing Jozien, Lagro-Janssen Antoine

机构信息

Department Primary and Community Care, Gender and Women's Health, Radboudumc, Nijmegen, The Netherlands.

Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, NIVEL, Utrecht, The Netherlands.

出版信息

Fam Pract. 2018 Mar 27;35(2):203-208. doi: 10.1093/fampra/cmx080.

Abstract

BACKGROUND

Empathy is regarded by patients and general practitioners (GPs) as fundamental in patient-GP communication. Patients do not always experience empathy and GPs encounter circumstances which hamper applying it.

OBJECTIVE

To explore why receiving and offering empathy during the encounter in general practice does not always meet the wishes of both patients and GPs.

METHOD

A qualitative research method, based on focus group interviews with patients and in-depth interviews with GPs, was carried out. Within the research process, iterative data collection and analysis were applied.

RESULTS

Both patients and GPs perceive a gap between what they wish for with regard to empathy, and what they actually encounter in general practice. Patients report on circumstances which hamper receiving empathy and GPs on circumstances offering it. Various obstacles were mentioned: (i) circumstances related to practice organization, (ii) circumstances related to patient-GP communication or connectedness, (iii) differences between the patient's and the GP's expectations, (iv) time pressure and its causes and (v) the GP's individual capability to offer empathy.

CONCLUSION

When patients do not receive empathy from their GP or practice staff, they feel frustrated. This causes a gap between their expectations on the one hand and their actual experiences on the other. GPs generally want to incorporate empathy; the GP's private, professional and psychological well-being appears to be an important contributing factor in practicing empathy in daily practice. But they encounter various obstacles to offer this. It is up to GPs to take responsibility for showing practice members the importance of an appropriate empathical behaviour towards patients.

摘要

背景

患者和全科医生(GP)都认为同理心是医患沟通的基础。患者并非总能感受到同理心,而全科医生也会遇到妨碍同理心应用的情况。

目的

探讨在全科医疗问诊过程中,接受和给予同理心为何并不总是能满足患者和全科医生双方的期望。

方法

采用定性研究方法,基于对患者的焦点小组访谈和对全科医生的深入访谈开展研究。在研究过程中,应用了迭代数据收集和分析方法。

结果

患者和全科医生都察觉到他们在同理心方面的期望与在全科医疗实际中所遇到的情况之间存在差距。患者报告了妨碍他们接受同理心的情况,全科医生则报告了给予同理心时遇到的情况。提到了各种障碍:(i)与诊所组织相关的情况;(ii)与医患沟通或联系相关的情况;(iii)患者和全科医生期望的差异;(iv)时间压力及其成因;(v)全科医生给予同理心的个人能力。

结论

当患者没有从他们的全科医生或诊所工作人员那里感受到同理心时,他们会感到沮丧。这导致了他们一方面的期望与另一方面的实际体验之间出现差距。全科医生通常希望融入同理心;全科医生的个人、职业和心理健康状况似乎是在日常实践中践行同理心的一个重要促成因素。但他们在给予同理心时会遇到各种障碍。全科医生有责任向诊所成员表明对患者采取适当同理心行为的重要性。

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