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从患者角度看,哪些患者和医生的行为能使医患交流更有效。一项涉及 31 个国家的欧洲多中心研究结果。

Which patient and doctor behaviours make a medical consultation more effective from a patient point of view. Results from a European multicentre study in 31 countries.

机构信息

University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Italy.

University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Italy.

出版信息

Patient Educ Couns. 2018 Oct;101(10):1795-1803. doi: 10.1016/j.pec.2018.05.019. Epub 2018 May 30.

Abstract

OBJECTIVE

To assess European patients' preferences regarding seven aspects of doctor-patient communication.

METHODS

6049 patients from 31 European countries evaluated 21 doctor and 12 patient behaviours, through a patient-generated questionnaire (PCVq). Multilevel models explored the effects of patient characteristics, contextual and cultural dimensions on preferences.

RESULTS

Patients attributed more responsibility to doctors, by giving greater importance to doctor than to patient factors, in particular to Treating the patient as a partner and as a person and Continuity of care. Gender, age, education, the presence of chronic illness and two of Hofstede's cultural dimensions, Individualism and Indulgence, showed differential evaluations among patients. Women gave greater importance to all seven communication aspects, older patients to being prepared for the consultation, lower educated patients to Treating patient as a person and Thoughtful planning. Patients from countries with an indulgent background rated all seven communication aspects of greater importance. A more individualistic orientation was related to lower importance regarding the four doctor's factors and the patient factor Open and Honest.

CONCLUSIONS

Treating the patient as a person and providing continuity of care emerged as universal values.

PRACTICE IMPLICATIONS

The findings should represent a landmark for the adaptation of patient-generated communication guidelines and programs in Europe.

摘要

目的

评估欧洲患者对医患沟通七个方面的偏好。

方法

来自 31 个欧洲国家的 6049 名患者通过患者生成问卷(PCVq)评估了 21 项医生和 12 项患者行为。多水平模型探讨了患者特征、情境和文化维度对偏好的影响。

结果

患者更倾向于将责任归咎于医生,认为医生因素比患者因素更重要,特别是将患者视为合作伙伴和个人以及提供连续的医疗服务。性别、年龄、教育程度、慢性疾病的存在以及霍夫斯泰德文化维度中的两个维度(个人主义和放纵)在患者中表现出不同的评价。女性更重视所有七个沟通方面,年龄较大的患者更重视为咨询做好准备,教育程度较低的患者更重视将患者视为个人和深思熟虑的计划。来自放纵文化背景的国家的患者对所有七个沟通方面的评价更为重要。更个人主义的取向与四个医生因素和患者因素的开放性和诚实性的重要性较低有关。

结论

将患者视为个人并提供连续的医疗服务是普遍的价值观。

实践意义

这些发现应该成为欧洲适应患者生成沟通指南和计划的里程碑。

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