临床沟通课程及影响医学生以患者为中心态度的其他因素。

Clinical communication course and other factors affecting patient-centered attitudes among medical students.

作者信息

Pers Michał, Górski Stanisław, Stalmach-Przygoda Agata, Balcerzak Łukasz, Szopa Magdalena, Karabinowska Alaksandra, Świerszcz Jolanta, Perera Ian, Cebula Grzegorz

机构信息

Department of Medical Education, Jagiellonian University Medical College, Kraków, Poland.

Department of Medical Education, Jagiellonian University Medical College, Kraków; Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland.

出版信息

Folia Med Cracov. 2019;59(2):81-92.

PMID:31659352

Abstract

OBJECTIVES

Patient-centered care (PCC) is associated with better relationships, resulting in a decrease in symptoms, hospitalizations and health costs. However, studies analyzing factors influencing patient-centered attitudes show ambiguous results. The purpose was to assess the impact of the Clinical Communication Course (CCC) in Jagiellonian University, Cracow and other factors on Patient-Centered Attitudes (PCA) and Attitude toward Clinical Skills Learning (CSLA).

METHODS

We retrospectively compared Polish-speakers (CCC+, n = 160), English-speakers (CCCen+, n = 55) after the CCC and upperclassmen Polish-speakers without it (CCC-, n = 122). Validated questionnaires to measure PCA (Leeds Attitude Toward Concordance II and Patient-Practitioner Orientation Scale (PPOS)) and for CSLA (Communication Skills Attitude Scale with negative subscale (CSAS-N)) were used. The higher the scores, the more PCA, and negative CSLA respectively. Students completed questionnaires and answered questions regarding age, sex, motivation to study (coded as humanitarian - MotHUM, financial - MotFIN, combination - MotMIX) and considered specialization - coded as with more human contact (family medicine, psychiatry, pediatrics - SpecHUM) and others (SpecNHUM). Statistics were prepared in R.

RESULTS

CCC+ scored higher in PPOS (2.91 vs. 2.74; p = 0.003) than CCC- and higher in CSAS-N than CCCen+ (31.22 vs. 28.32; p = 0.004). In CCC+ SpecHUM scored lower than SpecNHUM in PPOS (2.65 vs. 2.94, p = 0.012). MotFIN scored higher then MotMIX in PPOS (3.01 vs. 2.7, p = 0.036). Correlations were statistically significant.

CONCLUSION

CCC improved PCA in CCC+. They showed more negative CSLA than CCCen+. Among CCC+, surprisingly, SpecNHUM presented more PCA than SpecHUM as well as MotFIN compared to MotMIX.

摘要

目的

以患者为中心的护理（PCC）与更好的医患关系相关，可减少症状、住院次数和医疗费用。然而，分析影响以患者为中心态度的因素的研究结果并不明确。本研究旨在评估克拉科夫雅盖隆大学的临床沟通课程（CCC）及其他因素对以患者为中心的态度（PCA）和临床技能学习态度（CSLA）的影响。

方法

我们回顾性比较了参加CCC后的波兰语使用者（CCC +，n = 160）、英语使用者（CCCen +，n = 55）以及未参加CCC的高年级波兰语使用者（CCC -，n = 122）。使用经过验证的问卷来测量PCA（利兹一致性态度量表II和患者 - 从业者导向量表（PPOS））以及CSLA（带有负分量表的沟通技能态度量表（CSAS - N））。分数越高，分别表示PCA越强和CSLA越消极。学生完成问卷并回答有关年龄、性别、学习动机（编码为人道主义 - MotHUM、经济 - MotFIN、两者结合 - MotMIX）以及考虑的专业 - 编码为与人接触较多的专业（家庭医学、精神病学、儿科学 - SpecHUM）和其他专业（SpecNHUM）的问题。在R软件中进行统计分析。

结果

CCC +在PPOS中的得分高于CCC -（2.91对2.74；p = 0.003），在CSAS - N中的得分高于CCCen +（31.22对28.32；p = 0.004）。在CCC +中，SpecHUM在PPOS中的得分低于SpecNHUM（2.65对2.94，p = 0.012）。MotFIN在PPOS中的得分高于MotMIX（3.01对2.7，p = 0.036）。相关性具有统计学意义。