Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Primary and Community Care, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Scand J Prim Health Care. 2021 Mar;39(1):101-110. doi: 10.1080/02813432.2021.1882088. Epub 2021 Feb 11.
Many general practitioners (GPs) experience communication problems in medically unexplained symptoms (MUS) consultations as they are insufficiently equipped with adequate communication skills or do not apply these in MUS consultations.
To define the most important learnable communication elements during MUS consultations according to MUS patients, GPs, MUS experts and teachers and to explore how these elements should be taught to GPs and GP trainees.
Five focus groups were conducted with homogeneous groups of MUS patients, GPs, MUS experts and teachers. MUS patients and GPs formulated a list of important communication elements. MUS experts identified from this list the most important communication elements. Teachers explored how these elements could be trained to GPs and GP trainees. Two researchers independently analysed the data applying the principles of constant comparative analysis.
MUS patients and GPs identified a list of important communication elements. From this list, MUS experts selected five important communication elements: (1) thorough somatic and psychosocial exploration, (2) communication with empathy, (3) creating a shared understanding of the problem, (4) providing a tangible explanation and (5) taking control. Teachers described three teaching methods for these communication elements: (1) awareness and reflection of GPs about their feelings towards MUS patients, (2) assessment of GPs' individual needs and (3) training and supervision in daily practice.
Teachers consider a focus on personal attitudes and needs, which should be guided by opportunities to practice and receive supervision, as the best method to teach GPs about communication in MUS consultations.KEY POINTSMany GPs experience difficulties in communication with patients with MUS.There is a need to equip GPs with communication skills to manage MUS consultations more adequately.Role-playing with simulation patients, reflection on video-consultations and joint consultations with the supervisor may increase the GPs' awareness of their attitude towards MUS patients and may help GPs to identify their individual learning-points.
许多全科医生（GP）在处理无法用医学解释的症状（MUS）时存在沟通问题，因为他们缺乏足够的沟通技巧，或者在 MUS 咨询中没有应用这些技巧。
根据 MUS 患者、GP、MUS 专家和教师的意见，确定在 MUS 咨询中最重要的可学习沟通要素，并探讨如何向 GP 和 GP 受训者教授这些要素。
对 MUS 患者、GP、MUS 专家和教师这 5 个同质群体进行了 5 次焦点小组讨论。MUS 患者和 GP 列出了重要的沟通要素清单。MUS 专家从清单中确定了最重要的沟通要素。教师探讨了如何向 GP 和 GP 受训者教授这些要素。两名研究人员独立应用恒定性比较分析的原则对数据进行分析。
MUS 患者和 GP 列出了一份重要的沟通要素清单。MUS 专家从清单中选择了 5 项重要的沟通要素：（1）彻底的躯体和心理社会探索；（2）同理心沟通；（3）共同理解问题；（4）提供有形的解释；（5）控制局面。教师描述了这 5 项沟通要素的 3 种教学方法：（1）使 GP 意识到并反思他们对 MUS 患者的感受；（2）评估 GP 的个人需求；（3）在日常实践中进行培训和监督。
教师认为，关注个人态度和需求，并通过实践机会和接受监督来指导，是向 GP 教授 MUS 咨询中沟通技巧的最佳方法。
许多 GP 在与 MUS 患者沟通时存在困难。
需要为 GP 提供沟通技巧，以更妥善地处理 MUS 咨询。
角色扮演与模拟患者、对视频咨询的反思以及与主管的联合咨询，可能会提高 GP 对 MUS 患者的态度的认识，并帮助 GP 确定其个人的学习要点。
