Department of Medical, Health Professions Education, and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada (UGM), Indonesia.
Puskesmas (Primary Health Care Center) of Kretek, Bantul District, Yogyakarta Special Region, Indonesia.
Patient Educ Couns. 2020 Feb;103(2):292-300. doi: 10.1016/j.pec.2019.08.033. Epub 2019 Aug 26.
A partnership-oriented communication style is globally recommended for medical practice. A culturally-sensitive doctor-patient communication guideline is also needed for Southeast Asia. The 'Greet-Invite-Discuss' guideline was established and tested with primary care doctors and their patients in Indonesia.
In this mixed-methods study, doctors were trained according to the 'Greet-Invite-Discuss' guideline, while patients received standard treatment. Two groups of fifteen doctors were assigned to have consultations with 45 patients with hypertension or 51 patients with type-2 diabetes mellitus. Doctors' self-assessment and patients' perceptions and their clinical outcomes were longitudinally measured. Six focus group discussions were conducted to explore doctors' and patients' experiences.
Doctors' self-assessments and patients' perceptions of doctors' communication skills increased significantly (p < 0.05). Moreover, patients' blood pressure or fasting blood glucose levels decreased significantly (p < 0.05), except the two-hour blood glucose levels (NS). Qualitatively, doctors demonstrated more partnership and culturally-sensitive communication, and patients expressed more satisfaction, increased comprehension and self-management, of their chronic illnesses.
The 'Greet-Invite-Discuss' guideline was useful for primary care doctors for a more partnership-oriented and culturally-sensitive communication with patients in chronic care management.
Using a partnership-oriented and culturally-sensitive communication guideline, doctors can improve their communication skills with their patients towards optimum health outcomes.
全球范围内提倡采用以合作为导向的沟通方式进行医学实践。东南亚地区也需要制定一种具有文化敏感性的医患沟通指南。“问候-邀请-讨论”指南是在印度尼西亚的基层医疗医生及其患者中建立和测试的。
在这项混合方法研究中，医生根据“问候-邀请-讨论”指南接受培训，而患者接受标准治疗。将两组各 15 名医生分配给 45 名高血压患者或 51 名 2 型糖尿病患者进行咨询。对医生的自我评估以及患者的感知及其临床结果进行了纵向测量。进行了六次焦点小组讨论，以探讨医生和患者的经验。
医生的自我评估以及患者对医生沟通技巧的感知都有显著提高（p<0.05）。此外，患者的血压或空腹血糖水平显著降低（p<0.05），但两小时血糖水平无显著变化（NS）。定性分析表明，医生表现出更多的合作和具有文化敏感性的沟通，而患者则对慢性病的管理表示更满意，理解和自我管理能力增强。
“问候-邀请-讨论”指南对于基层医疗医生在慢性病管理中与患者进行更具合作性和文化敏感性的沟通是有用的。
使用以合作为导向和具有文化敏感性的沟通指南，医生可以提高与患者的沟通技巧，从而获得最佳的健康结果。
