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医患沟通技巧:伊朗家庭医生知识与实践调查。

Doctor-patient communication skills: a survey on knowledge and practice of Iranian family physicians.

机构信息

Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

BMC Fam Pract. 2021 Jun 24;22(1):130. doi: 10.1186/s12875-021-01491-z.

Abstract

BACKGROUND

Communication skills are fundamental to successful medical practice and can greatly impact patient satisfaction, compliance and outcomes. This study evaluated knowledge and practice of doctor- patient communication among the urban family physicians based on main items of Calgary Cambridge Observation Guides.

METHOD

This cross-sectional study was conducted from July to September, 2019, in a 400 randomly selected sample of family physicians of Shiraz, Fars province. The data collection tool was a self-administered, second-part questionnaire developed by the researchers. Participants were asked about their age, gender, practice setting, and years of work experience and if they received any formal training in doctor- patient communication. Data were analyzed using SPSS (Version 16, SPSS Inc., Chicago, IL, USA). A p-value of less than 0.05 was considered statistically significant.

RESULTS

The study participants included 204 male and 196 female family physicians with a mean age of 46.7 ± 7.7 years. The mean communication skills knowledge score was 41.5 (SD: ± 2.8) indicating a high level of knowledge. The mean score for practices was 38.7 (SD: ± 3.4), implying a moderate level of practice. Based on Bloom's scale, nearly 80% of family physicians had good knowledge about doctor-patient communication skills, however, 55% of participants reported moderate to poor level of practice in this regard. Results of multivariate regression analysis suggest that higher levels of related knowledge, having higher age or longer work experience, and working in the public sector can predict better practice scores (P < 0.005).

CONCLUSION

There is a potential gap between knowledge and self-reported practices toward communication skills among a sample of Iranian family physicians. They have fundamental weakness in the most important evidence-based items of doctor- patient communication. Considering significant role of family physicians in prevention and control of non-communicable diseases (NCDs) as an emerging challenge of our country, the topic of communication skills should be inserted as a top educational priority of family physicians.

摘要

背景

沟通技巧是成功医疗实践的基础,对患者满意度、依从性和治疗结果有重大影响。本研究根据卡尔加里-剑桥观察指南的主要项目,评估了城市家庭医生的医患沟通知识和实践情况。

方法

本横断面研究于 2019 年 7 月至 9 月在法尔斯省设拉子的 400 名随机选择的家庭医生中进行。数据收集工具是研究人员开发的第二部分自我管理问卷。参与者被问及他们的年龄、性别、执业环境以及工作经验年限,以及是否接受过医患沟通方面的正式培训。使用 SPSS(版本 16,SPSS Inc.,芝加哥,IL,USA)进行数据分析。p 值小于 0.05 被认为具有统计学意义。

结果

研究参与者包括 204 名男性和 196 名女性家庭医生,平均年龄为 46.7±7.7 岁。沟通技巧知识评分的平均值为 41.5(标准差:±2.8),表明知识水平较高。实践评分的平均值为 38.7(标准差:±3.4),暗示实践水平中等。根据布鲁姆量表,近 80%的家庭医生对医患沟通技巧有较好的了解,但 55%的参与者报告在这方面的实践水平为中等至较差。多元回归分析的结果表明,相关知识水平较高、年龄较大或工作经验较长、在公共部门工作可以预测更好的实践评分(P<0.005)。

结论

在伊朗家庭医生样本中,沟通技巧的知识与自我报告的实践之间存在潜在差距。他们在医患沟通的最重要的基于证据的项目上存在根本弱点。考虑到家庭医生在预防和控制非传染性疾病(NCDs)方面的重要作用,这是我们国家面临的一个新兴挑战,沟通技巧应作为家庭医生的首要教育重点。

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