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以患者为中心的沟通是怎样的?:医疗服务提供者关怀式护理和共同决策的语言标志及其对患者治疗结果的影响。

What Does Patient-Centered Communication Look Like?: Linguistic Markers of Provider Compassionate Care and Shared Decision-Making and Their Impacts on Patient Outcomes.

作者信息

Zhou Yanmengqian, Acevedo Callejas Michelle L, Li Yuwei, MacGeorge Erina L

机构信息

Department of Communication Arts & Sciences, State College, Pennsylvania State University.

出版信息

Health Commun. 2023 May;38(5):1003-1013. doi: 10.1080/10410236.2021.1989139. Epub 2021 Oct 17.

DOI:10.1080/10410236.2021.1989139
PMID:34657522
Abstract

Patient-centered communication promotes positive patient outcomes. This study examines the linguistic markers of two key dimensions of patient-centered communication (i.e., provider compassionate care and shared decision-making) and their mediating effects on patient perceived quality of and affective responses to the provider's treatment recommendations. Transcripts ( = 343) of provider talk from provider-patient interactions in medical visits for upper respiratory infection symptoms where patients were not prescribed with antibiotics were analyzed with the Linguistic Inquiry and Word Count (LIWC) dictionary. Results showed that providers' use of affiliation words positively predicted patients' perceptions of their providers' compassionate care. Providers' use of insight words negatively predicted patients' perceptions of provider shared decision-making. Meanwhile, providers' use of first-person singular pronouns, causation and differentiation words, and clout words were positively related to perceived provider shared decision-making. Patient perceived compassionate care and shared decision-making further increased patients' positive affect toward and perceived quality of non-antibiotic treatment recommendations. These perceptions also reduced their negative affect toward the recommendations. Implications of the findings are discussed with regard to patient-centered communication in relation to the promotion of antibiotic stewardship.

摘要

以患者为中心的沟通可促进患者获得积极的治疗结果。本研究考察了以患者为中心的沟通两个关键维度(即医疗服务提供者的关怀照护和共同决策)的语言标记,以及它们对患者对医疗服务提供者治疗建议的感知质量和情感反应的中介作用。使用语言查询与字数统计(LIWC)词典,对未开具抗生素处方的上呼吸道感染症状就诊中医疗服务提供者与患者互动时医疗服务提供者谈话的文字记录(n = 343)进行了分析。结果表明,医疗服务提供者使用亲和性词汇可正向预测患者对其关怀照护的感知。医疗服务提供者使用洞察性词汇可负向预测患者对医疗服务提供者共同决策的感知。同时,医疗服务提供者使用第一人称单数代词、因果关系和区分性词汇以及影响力词汇与感知到的医疗服务提供者共同决策呈正相关。患者感知到的关怀照护和共同决策进一步增强了患者对非抗生素治疗建议的积极情感和感知质量。这些感知也减少了他们对这些建议的消极情感。研究结果的意义针对促进抗生素管理方面的以患者为中心的沟通进行了讨论。

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