Department of Psychiatry, Coimbra University and Hospital Centre, Coimbra, Portugal.
Department of Research, Nursing School of Coimbra, Coimbra, Portugal.
Psychiatry Res. 2018 Nov;269:13-20. doi: 10.1016/j.psychres.2018.08.040. Epub 2018 Aug 14.
Communication plays a central role in mental health care. Yet, studies fail to address the adequacy of psychiatrists' communication according to patients' needs. We examined how patients with schizophrenia assess their psychiatrists' communication skills, inspecting the importance that these aspects have for patients. Thirty patients with schizophrenia filled the Communication Assessment Tool after the appointment with their psychiatrists. An external observer also rated the videotaped appointments using the same instrument. Patients' mean rating of their psychiatrists' communication was 4.28 (mean proportion of excellent, "5" scores, was 57.4%). "Treated me with respect" received the highest mean, whereas "Encouraged me to ask questions" received the lowest. The assessment by the external observer was concordant, though lower (mean = 3.39) than patients'. Psychiatrists' communication skills correlated positively with the importance that patients gave to the respective communication aspects (overall mean importance = 2.77). Main discrepancies were related with "Understood my concerns" and "Involved me in decisions". Patients who were non-married, with higher education level and in medical treatment for less time gave significantly higher scores to psychiatrists' communication. Patients with schizophrenia consider clinical communication important and their psychiatrists' communication adequate. Room for improvement exists, namely regarding more elicitation of patients' health concerns and involvement in the encounter.
沟通在心理健康护理中起着核心作用。然而，研究未能根据患者的需求来评估精神科医生沟通的充分性。我们研究了精神分裂症患者如何评估他们的精神科医生的沟通技巧，考察了这些方面对患者的重要性。30 名精神分裂症患者在与精神科医生预约后填写了沟通评估工具。一名外部观察员还使用相同的工具对录像预约进行了评分。患者对其精神科医生沟通的平均评分是 4.28（优秀，“5”分的平均比例为 57.4%）。“尊重我”获得的平均分最高，而“鼓励我提问”则获得的平均分最低。外部观察员的评估与患者的评估一致，但略低（平均值为 3.39）。精神科医生的沟通技巧与患者对各个沟通方面的重视程度呈正相关（总体平均重视程度为 2.77）。主要差异与“理解我的担忧”和“让我参与决策”有关。未婚、受教育程度较高、治疗时间较短的患者对精神科医生的沟通评分显著更高。精神分裂症患者认为临床沟通很重要，他们的精神科医生的沟通也足够充分。仍有改进的空间，特别是在更深入地了解患者的健康问题和让患者参与治疗方面。
