Thomas Samantha, O'Loughlin Kate, Clarke Jillian
Faculty of Health Sciences University of Sydney Cumberland Campus Lidcombe New South Wales 1825 Australia.
Faculty of Health Sciences, Ageing, Work and Health Research Unit University of Sydney Cumberland Campus Lidcombe New South Wales 1825 Australia.
Australas J Ultrasound Med. 2019 Nov 2;23(2):129-139. doi: 10.1002/ajum.12184. eCollection 2020 May.
INTRODUCTION/PURPOSE: Despite the clinical importance of patient-centred care in the sonographer/patient interaction in obstetric ultrasound, there has been very little current research in Australia on sonographer and sonologist communication practices in the event of an adverse finding. This study sought the views, experiences and practices of Australian sonographers, particularly in relation to adverse findings, with consideration of the implications for their professional role and practice.
Qualified and trainee sonographers who perform obstetric ultrasound were invited to complete a survey through the Australasian Sonographers Association. Using qualitative methodology, the authors developed themes on a range of issues related to sonographer and sonologist communication practices and roles from responses to three open-ended questions within the survey.
Analysis of 249 responses revealed three distinct 'Communicator types'. 'Open Communicators' confidently practice open and direct communication; 'Limited Communicators' perceived barriers preventing them from openly communicating; 'Variable Communicators' indicated various challenging 'grey areas' which created inconsistent communication practices. Variables, such as the complexity of an adverse finding and a reporting sonologist's role, attitude and level of control they exercised over sonographer communication, all influenced respondents' communication practices. Respondents believed professional bodies should agree on a standardised policy regarding sonographers' roles.
This paper highlights the complexity of the sonographer/patient interaction and outlines the difficulty in providing true patient-centred care in obstetric ultrasound.
The need for a collaborative, patient-focussed policy, which defines and recognises the role of the sonographer in the event of obstetric adverse findings, will improve the current model of care.
引言/目的：尽管以患者为中心的护理在产科超声检查中超声医师与患者的互动中具有临床重要性，但目前澳大利亚关于超声医师和超声科医生在出现不良检查结果时的沟通实践的研究非常少。本研究旨在了解澳大利亚超声医师的观点、经验和实践，特别是关于不良检查结果的情况，并考虑其对专业角色和实践的影响。
邀请从事产科超声检查的合格和实习超声医师通过澳大利亚超声医师协会完成一项调查。作者采用定性方法，根据对调查中三个开放式问题的回答，就与超声医师和超声科医生沟通实践及角色相关的一系列问题形成了主题。
对249份回复的分析揭示了三种不同的“沟通者类型”。“开放沟通者”自信地进行开放和直接的沟通；“有限沟通者”察觉到阻碍他们进行开放沟通的障碍；“可变沟通者”指出了各种具有挑战性的“灰色地带”，这些地带导致沟通实践不一致。诸如不良检查结果的复杂性以及报告超声科医生的角色、态度和对超声医师沟通的控制程度等变量，都影响了受访者的沟通实践。受访者认为专业机构应该就超声医师角色的标准化政策达成一致。
本文强调了超声医师与患者互动的复杂性，并概述了在产科超声检查中提供真正以患者为中心的护理的困难。
需要一项以患者为重点的协作性政策，该政策应明确并认可超声医师在产科出现不良检查结果时的角色，这将改善当前的护理模式。
