Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
Unit of Medical Statistics, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
BMC Fam Pract. 2019 Jun 15;20(1):83. doi: 10.1186/s12875-019-0959-y.
We designed this observational study to investigate the level of patients' and doctors' ratings of patient-centred aspects of the primary care consultation.
Questionnaire study with patients and doctors. Consecutive patients in a primary care setting and 16 doctors responding post visit. Results are presented as proportions with 95% confidence intervals.
411 questionnaires, 223 from patients and 188 from doctors, covered 251 consultations. Both patients and doctors gave the highest possible estimations on the aspects of patient-centred communication and satisfaction less frequently when the patient had other reasons for visit than purely somatic. Unlike the doctors' estimations, the frequency of highest possible estimations in patient responses dropped if the patients had two to six reasons for visit rather than one. Among the six patient-centred aspects, both patients and doctors gave the highest possible estimation least frequently on the aspect of shared decision-making.
The results suggest that the nature of the reason, as well as the number of reasons for visit, interferes with the doctors' level of patient-centred communication. Our results furthermore confirm the findings of previous studies that doctors insufficiently involve patients in their care.
我们设计了这项观察性研究，旨在调查患者和医生对初级保健咨询中以患者为中心的方面的评分水平。
患者和医生的问卷调查研究。在初级保健环境中连续就诊的患者和 16 名就诊后回复的医生。结果以比例和 95%置信区间表示。
411 份问卷，其中 223 份来自患者，188 份来自医生，涵盖了 251 次就诊。当患者就诊的原因不仅是躯体疾病时，患者和医生对以患者为中心的沟通和满意度方面给出了最高可能评分的可能性较小。与医生的评估不同，如果患者有两个到六个就诊原因而不是一个，那么患者对最高可能评分的频率会下降。在六个以患者为中心的方面中，患者和医生对共同决策方面给出了最高可能评分的可能性最小。
研究结果表明，就诊原因的性质以及就诊原因的数量会干扰医生以患者为中心的沟通水平。我们的研究结果进一步证实了先前研究的发现，即医生在治疗中未能充分让患者参与。
