Department of Radiology, University of California, Davis, Sacramento, California.
Breast Imaging Division, Duke University Medical Center, Durham, North Carolina.
J Am Coll Radiol. 2019 May;16(5):709-716. doi: 10.1016/j.jacr.2018.10.016. Epub 2018 Dec 21.
The aim of this study was to assess variability in radiologist-patient communication practices and barriers to communication among members of the Society of Breast Imaging (SBI).
A 36-item questionnaire developed by the SBI Patient Care and Delivery Task Force was distributed electronically to SBI members to evaluate patient communication, education, and screening practices. Data from 14 items investigating patient communication (eg, practices, comfort, barriers to communication) were analyzed and compared with demographic variables using χ or independent t tests as appropriate.
Ninety-three percent of radiologists reported that they directly communicate abnormal results of diagnostic mammographic examinations that require biopsy and malignant or high-risk biopsy results that require surgery. Radiologists (66%) and technologists (57%) often provide normal or negative diagnostic mammographic results. Most respondents were completely comfortable discussing the need for additional imaging, recommending biopsy, and discussing biopsy results directly with patients, and 71% rated their communication skills as excellent. Radiologists who spend less time in breast imaging reported only average communication skills. The most frequent barriers to communication were that practices were not set up for direct communication (loss of revenue) and discomfort with angry patients.
Although variation in breast imaging communication practices exists among radiologists and practice types, the majority of radiologists directly communicate the most distressing results to patients, such as those regarding abnormal diagnostic mammographic findings requiring biopsies and abnormal biopsy results leading to cancer diagnoses and surgery. The majority of radiologists are completely comfortable with these conversations, but all feel that enhancing communication with patients will lead to greater patient satisfaction.
本研究旨在评估乳腺成像学会（SBI）成员之间放射科医生与患者沟通实践的差异和沟通障碍。
SBI 患者护理和交付工作组制定了一份 36 项的问卷，通过电子邮件分发给 SBI 成员，以评估患者沟通、教育和筛查实践。分析了调查患者沟通（例如实践、舒适度、沟通障碍）的 14 项数据，并与人口统计学变量进行了比较，适当使用了 χ 或独立 t 检验。
93%的放射科医生报告说，他们直接沟通需要活检的诊断性乳腺 X 线摄影检查的异常结果和需要手术的恶性或高风险活检结果。放射科医生（66%）和技术员（57%）经常提供正常或阴性的诊断性乳腺 X 线摄影结果。大多数受访者完全愿意讨论需要额外成像、推荐活检以及直接与患者讨论活检结果，并且 71%的人认为他们的沟通技巧非常出色。在乳腺成像中花费时间较少的放射科医生仅报告了平均沟通技巧。沟通障碍最常见的原因是没有建立直接沟通的实践（收入损失）和对愤怒患者的不适。
尽管放射科医生和实践类型之间存在乳腺成像沟通实践的差异，但大多数放射科医生直接向患者传达最令人痛苦的结果，例如那些需要活检的异常诊断性乳腺 X 线摄影结果和导致癌症诊断和手术的异常活检结果。大多数放射科医生对这些对话完全感到舒适，但他们都认为与患者加强沟通将提高患者满意度。
