“我们在同一队”：创伤患者与外科住院医师之间的沟通（障碍）。
"We're playing on the same team": Communication (dis)connections between trauma patients and surgical residents.
机构信息
From the University of Chicago, Pritzker School of Medicine (A.K.H., P.-A.C., S.W., H.O.P., K.C., F.T., A.A., I.L.H., I.H.), Chicago, Illinois; Department of Surgery (M.J.C.), University of California San Francisco-East Bay, Oakland, California; Department of Psychiatry and Department of Family and Community Medicine (S.S.), University of Toronto, Toronto, ON, Canada; Department of Medicine (D.M.), University of Chicago; Department of Psychiatry and Behavioral Neurosciences (S.D.), Department of Pediatrics (B.S.), Crown School of Social Work (F.C.G.), Section of Pediatric Surgery, Department of Surgery (M.H., M.S., D.M., S.D., B.S., F.C.G.), University of Chicago, Chicago, Illinois; Department of Anthropology (J.R.), University of Maryland, College Park, Maryland; Miller School of Medicine (Z.B.), University of Miami, Miami, Florida; and Section of Trauma and Acute Care Surgery, Department of Surgery (T.O., E.W., V.B., C.H., M.X.F., J.R., T.Z.), University of Chicago, Chicago, Illinois.
出版信息
J Trauma Acute Care Surg. 2023 Jan 1;94(1):93-100. doi: 10.1097/TA.0000000000003663. Epub 2022 May 12.
BACKGROUND
Patient-physician communication is key to better clinical outcomes and patient well-being. Communication between trauma patients and their physicians remains relatively unexplored. We aimed to identify and characterize the range of strengths and challenges in patient-physician communication in the setting of trauma care.
METHODS
A qualitative, grounded theory approach was used to explore communication strengths and challenges for patients and residents. Patients previously admitted to the trauma service for violent injuries were recruited and interviewed in-person during their trauma clinic appointments. Surgical residents were recruited via email and interviewed virtually via Zoom. Anonymous, semistructured interviews were conducted until thematic saturation was reached.
RESULTS
Twenty-nine interviews with patients and 14 interviews with residents were conducted. Patients reported feeling ignored and misunderstood and having inadequate communication with physicians. Residents cited lack of time, patients' lack of health literacy, differences in background, and emotional responses to trauma as barriers to effective communication with patients. Patients and residents reported an understanding of each other's stressors, similar emotional experiences regarding traumatic stress, and a desire to communicate with each other in greater depth both inside and outside of the hospital.
CONCLUSION
Trauma patients and residents can feel disconnected due to the lack of time for thorough communication and differences in background; however, they understand each other's stressors and share similar emotional responses regarding trauma and a desire for increased communication, connection, and solidarity. Leveraging these shared values to guide interventions, such as a resident curriculum, may help bridge disconnects and improve their communication.
LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
背景
医患沟通是改善临床结果和患者福祉的关键。创伤患者与医生之间的沟通仍然相对缺乏探索。我们旨在确定和描述创伤护理环境中患者与医生之间沟通的优势和挑战范围。
方法
采用定性、扎根理论方法探讨患者和住院医师在沟通方面的优势和挑战。招募了先前因暴力受伤而被送入创伤科的患者，并在他们的创伤诊所预约期间进行了面对面的采访。通过电子邮件招募外科住院医师，并通过 Zoom 进行虚拟采访。进行匿名、半结构化访谈，直到达到主题饱和度。
结果
对 29 名患者和 14 名住院医师进行了访谈。患者报告感到被忽视和误解，与医生的沟通不足。住院医师提到缺乏时间、患者健康素养不足、背景差异以及对创伤的情绪反应是与患者有效沟通的障碍。患者和住院医师报告理解彼此的压力源、对创伤相关压力有相似的情绪反应，以及希望在医院内外更深入地沟通。
结论
由于缺乏彻底沟通的时间和背景差异，创伤患者和住院医师可能会感到脱节；然而，他们理解彼此的压力源，并对创伤和增加沟通、联系和团结的愿望有相似的情绪反应。利用这些共同的价值观来指导干预措施，例如住院医师课程，可能有助于弥合脱节并改善他们的沟通。
证据水平
治疗/护理管理；等级 IV。
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