Department of Psychology, 806 W. Franklin St. Box 84-2018, Virginia Commonwealth University, Richmond, VA 23284, USA.
Ray and Stephanie Lane Center for Computational Biology, Carnegie Mellon University, 5000 Forbes Ave Suite 7725, Pittsburgh, PA 15213, USA.
Soc Sci Med. 2018 Feb;198:22-26. doi: 10.1016/j.socscimed.2017.12.021. Epub 2017 Dec 18.
Patient-physician communication plays an essential role in a variety of patient outcomes; however, it is often difficult to operationalize positive patient-physician communication objectively, and the existing evaluation tools are generally time-consuming.
This study proposes semantic similarity of the patient's and physician's language in a medical interaction as a measure of patient-physician communication. Latent semantic analysis (LSA), a mathematical method for modeling semantic meaning, was employed to assess similarity in language during clinical interactions between physicians and patients.
Participants were 132 Black/African American patients (76% women, Mage = 43.8, range = 18-82) who participated in clinical interactions with 17 physicians (53% women, Mage = 27.1, range = 26-35) in a primary care clinic in a large city in the Midwestern United States.
LSA captured reliable information about patient-physician communication: The mean correlation indicating similarity between the transcripts of a physician and patient in a clinical interaction was 0.142, significantly greater than zero; the mean correlation between a patient's transcript and transcripts of their physician during interactions with other patients was not different from zero. Physicians differed significantly in the semantic similarity between their language and that of their patients, and these differences were related to physician ethnicity and gender. Female patients exhibited greater communication similarity with their physicians than did male patients. Finally, greater communication similarity was predicted by less patient trust in physicians prior to the interaction and greater patient trust after the interaction.
LSA is a potentially important tool in patient-physician communication research. Methodological considerations in applying LSA to address research questions in patient-physician communication are discussed.
医患沟通在各种患者结局中起着至关重要的作用；然而，客观地操作积极的医患沟通通常具有挑战性，并且现有的评估工具通常很耗时。
本研究提出医患医疗互动中患者和医生语言的语义相似性作为医患沟通的衡量标准。潜在语义分析（LSA）是一种用于建模语义含义的数学方法，用于评估医生和患者之间临床互动中语言的相似性。
参与者是 132 名非裔美国患者（76%为女性，平均年龄为 43.8 岁，范围为 18-82 岁），他们在美国中西部一个大城市的初级保健诊所与 17 名医生（53%为女性，平均年龄为 27.1 岁，范围为 26-35 岁）进行了临床互动。
LSA 捕捉到了有关医患沟通的可靠信息：指示临床互动中医生和患者转录本之间相似性的平均相关系数为 0.142，显著大于零；患者转录本与他们在与其他患者互动时的医生转录本之间的平均相关系数与零无差异。医生的语言与患者语言之间的语义相似性存在显著差异，并且这些差异与医生的种族和性别有关。女性患者与医生的沟通相似度明显大于男性患者。最后，在互动前患者对医生的信任度越低，互动后患者对医生的信任度越高，沟通相似度越大。
LSA 是医患沟通研究中的一种潜在重要工具。讨论了在应用 LSA 解决医患沟通研究中的研究问题时的方法学考虑因素。
