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迪拜全科诊疗中心环境下家庭医生与患者之间有效沟通的障碍:一项横断面调查。

Barriers to effective communication between family physicians and patients in walk-in centre setting in Dubai: a cross-sectional survey.

作者信息

Albahri Abdulaziz H, Abushibs Alya S, Abushibs Noura S

机构信息

Medical Education Department, Dubai Healthcare Authority, P.O. Box: 4545, Dubai, United Arab Emirates.

出版信息

BMC Health Serv Res. 2018 Aug 14;18(1):637. doi: 10.1186/s12913-018-3457-3.

Abstract

BACKGROUND

Effective communication between family physicians and their patients is crucial to improving healthcare outcomes and patients' satisfaction. However, the barriers to effective communication have been weakly studied in the Gulf region with no reported studies in Dubai. This study aims to identify the main perceived barriers to effective communication between patients and their family physicians in Dubai from both the physicians' and the patients' viewpoints.

METHODS

The study was conducted at 12 primary healthcare centres in Dubai between October 2016 - July 2017. Two self-administered questionnaires were used, one measuring the patients' perceived frequency of encounters with barriers to communication, while the other was for the family physicians' perceived level of risk to communication posed by the barriers. The barriers were assessed in the following four domains: personal characteristics and attitudes, organisational factors, communication of information, and linguistic and cultural factors.

RESULTS

There were a total of 1122 patients and 170 family physicians, with 75% and 85% response rates, respectively. Having a time limitation was the highest ranking barrier, with 23.4% of patients encountering it half of the time-always, and 50.6% of physicians perceiving it as moderate-very high risk. This was followed by barriers in the communication of information domain, especially not checking the patient's understanding and not educating the patient (16.0-16.9%) from the patients' perception and presentation with multiple problems and not following with a treatment plan (51.2% and 35.9%, respectively), from the physicians' perception. Preoccupation with medical records ranked in the second pentile for the physicians, and in the lowest pentile for the patients. Barriers related to the failure of rapport building and linguistic/cultural factors ranked in the fourth and fifth pentiles for both patients and physicians.

CONCLUSION

Time pressure is the major perceived barrier to communication between patients and family physicians. In addition, a greater focus needs to be placed on training the physicians to convey their messages to the patients clearly, checking their understanding and managing poor historians.

摘要

背景

家庭医生与患者之间的有效沟通对于改善医疗保健效果和患者满意度至关重要。然而,海湾地区对有效沟通障碍的研究较少,迪拜尚无相关报道。本研究旨在从医生和患者的角度确定迪拜患者与其家庭医生之间有效沟通的主要感知障碍。

方法

该研究于2016年10月至2017年7月在迪拜的12个初级医疗保健中心进行。使用了两份自填式问卷,一份测量患者感知到的沟通障碍发生频率,另一份测量家庭医生感知到的障碍对沟通造成的风险水平。在以下四个领域评估障碍:个人特征和态度、组织因素、信息沟通以及语言和文化因素。

结果

共有1122名患者和170名家庭医生参与,回应率分别为75%和85%。时间限制是排名最高的障碍,23.4%的患者有时总是遇到,50.6%的医生认为这是中度至非常高的风险。其次是信息沟通领域的障碍,特别是从患者的角度来看,未检查患者的理解情况和未对患者进行教育(16.0 - 16.9%),以及从医生的角度来看,同时出现多个问题且未遵循治疗计划(分别为51.2%和35.9%)。专注于病历对医生来说排在第二五分位数,对患者来说排在最低五分位数。与建立融洽关系失败和语言/文化因素相关的障碍在患者和医生中均排在第四和第五五分位数。

结论

时间压力是患者与家庭医生沟通中主要的感知障碍。此外,需要更加注重培训医生,使其能够清晰地向患者传达信息,检查患者的理解情况,并应对病史叙述不佳的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/6092839/76fe1a69da42/12913_2018_3457_Fig1_HTML.jpg

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