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医患沟通如何影响对健康信息源的信任:来自全国横断面调查的时间趋势。

How clinician-patient communication affects trust in health information sources: Temporal trends from a national cross-sectional survey.

机构信息

School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey, United States of America.

Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.

出版信息

PLoS One. 2021 Feb 25;16(2):e0247583. doi: 10.1371/journal.pone.0247583. eCollection 2021.

Abstract

BACKGROUND

Understanding patients' trust in health information sources is critical to designing work systems in healthcare. Patient-centered communication during the visit might be a major factor in shaping patients' trust in information sources.

OBJECTIVE

The purpose of this paper is to explore relationships between patient ratings of clinician communication during the visit and patient trust in health information sources.

METHODOLOGY

We conducted a secondary analysis of the nationally-representative Health Information National Trends Surveys; HINTS4 Cycle1 (2011), HINTS4 Cycle4 (2014), and HINTS5 Cycle1 (2017), and HINTS5 Cycle2 (2018). We created a composite score of patient-centered communication from five questions and dichotomized at the median. We created multivariable logistic regression models to see how patient-centered communication influenced trust in different information sources across cycles. Consecutively, we used hierarchical analysis for aggregated data.

RESULTS

We analyzed data from 14,425 individuals. In the adjusted logistic models for each cycle and the hierarchical model, clinicians' perceived patient-centered communication skills were significantly associated with increased trust in the clinicians as an information source.

CONCLUSION

Clinicians still represent an essential source of trustworthy information reinforced by patient-centered communication skills. Given that trust helps build healing relationships that lead to better healthcare outcomes, communication sets an essential foundation to establish necessary trust. Interpreting information from the internet sources for patients is likely to remain a vital clinician function.

摘要

背景

了解患者对健康信息来源的信任对于设计医疗保健工作系统至关重要。就诊期间以患者为中心的沟通可能是塑造患者对信息来源信任的主要因素。

目的

本文旨在探讨就诊期间患者对临床医生沟通的评价与患者对健康信息来源的信任之间的关系。

方法

我们对具有全国代表性的健康信息国家趋势调查(HINTS)进行了二次分析;HINTS4 周期 1(2011 年)、HINTS4 周期 4(2014 年)和 HINTS5 周期 1(2017 年)以及 HINTS5 周期 2(2018 年)。我们从五个问题中创建了一个以患者为中心的沟通综合评分,并将其按中位数进行二分。我们创建了多变量逻辑回归模型,以了解患者为中心的沟通如何影响不同周期内对不同信息来源的信任。随后,我们使用层次分析对汇总数据进行了分析。

结果

我们分析了来自 14425 人的数据。在每个周期的调整后逻辑模型和层次模型中,临床医生感知到的以患者为中心的沟通技巧与对临床医生作为信息来源的信任增加显著相关。

结论

临床医生仍然是可靠信息的重要来源,这一地位通过以患者为中心的沟通技巧得到加强。鉴于信任有助于建立促进更好医疗效果的治疗关系,沟通为建立必要的信任奠定了重要基础。为患者解读互联网来源的信息可能仍然是临床医生的一项重要职能。

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