Zhumadilova Anara, Craig Brett J, Tsoy Alexey, Gabdrakhmanova Alla, Bobak Martin
School of Science and Technology, Nazarbayev University, Astana, Kazakhstan.
Astana City Hospital #1, Astana, Kazakhstan.
Cent Asian J Glob Health. 2014 Jan 24;2(Suppl):82. doi: 10.5195/cajgh.2013.82. eCollection 2013.
Communication between patients and health care providers is important for the effective functioning of health care systems. Miscommunication often stems from discrepancies in expectations of both healthcare professionals and patients due to cultural and historical influences. We investigated the degree to which health care providers (doctors and nurses) and patients in Kazakhstan believe that interaction between doctors and patients should be doctor- or patient-oriented.
We conducted a cross-sectional study of 163 patients and 176 health care providers (71 doctors and 105 nurses) in a general hospital in Astana, Kazakhstan. The subjects completed a structured questionnaire containing the Patient-Practitioner Orientation Scale (PPOS), and scales assessing life and job satisfaction, effort-reward balance of healthcare professionals, and the patients' perceptions of communication practices.
An overwhelming majority of doctors (81.7%), nurses (88.1%), and patients (92.3%) were doctor-oriented. Among health care providers, PPOS was not associated with age, sex, life and job satisfaction, or effort-reward imbalance. Among patients, PPOS was not associated with age, sex, or specialty of health care provider. However, higher PPOS among patients (indicating preference for patient-oriented interaction) was associated with higher satisfaction with communication with health care providers and, less strongly, with their life satisfaction.
The main finding of this study is the very small proportion of doctors, nurses and patients who believe that interaction should be patient-oriented. These results highlight the necessity of improvement of communication among health care providers towards patient-oriented approach in order to decrease miscommunication with patients. The fact that most patients prefer doctor-oriented interaction may reflect historical stereotypes; educational/information interventions among patients may also be needed.
患者与医疗服务提供者之间的沟通对于医疗系统的有效运作至关重要。由于文化和历史影响，沟通不畅往往源于医疗专业人员和患者期望上的差异。我们调查了哈萨克斯坦的医疗服务提供者（医生和护士）以及患者认为医患互动应以医生为导向还是以患者为导向的程度。
我们在哈萨克斯坦阿斯塔纳的一家综合医院对163名患者和176名医疗服务提供者（71名医生和105名护士）进行了横断面研究。受试者完成了一份结构化问卷，其中包含患者-从业者导向量表（PPOS），以及评估生活和工作满意度、医疗专业人员的努力-回报平衡以及患者对沟通方式看法的量表。
绝大多数医生（81.7%）、护士（88.1%）和患者（92.3%）都倾向于以医生为导向。在医疗服务提供者中，PPOS与年龄、性别、生活和工作满意度或努力-回报失衡无关。在患者中，PPOS与年龄、性别或医疗服务提供者的专业无关。然而，患者中较高的PPOS（表明倾向于以患者为导向的互动）与对与医疗服务提供者沟通的更高满意度相关，与生活满意度的相关性较弱。
本研究的主要发现是，认为互动应以患者为导向的医生、护士和患者比例非常小。这些结果凸显了医疗服务提供者之间改进沟通以采用以患者为导向的方法的必要性，以减少与患者的沟通不畅。大多数患者更喜欢以医生为导向的互动这一事实可能反映了历史刻板印象；可能还需要对患者进行教育/信息干预。
