Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.
Program Older Adults and Health, Pharos, Dutch Centre of Expertise on Health Disparities, Utrecht, Netherlands.
PLoS One. 2022 Jun 9;17(6):e0269677. doi: 10.1371/journal.pone.0269677. eCollection 2022.
Effective communication in specialist consultations is difficult for some patients. These patients could benefit from support from a coach who accompanies them to and during medical specialist consultations to improve communication in the consultation room. This study aims to investigate patients' perspective on interest in support from a patient coach, what kind of support they would like to receive and what characterizes an ideal patient coach.
We applied a mixed method design to obtain a realistic understanding of patients' perspectives on a patient coach. Patients in the waiting rooms of outpatient clinics were asked to fill out a short questionnaire which included questions about demographic characteristics, perceived efficacy in patient-provider interaction and patients' interest in support from a patient coach. Subsequently, patients interested in a patient coach were asked to participate in a semi-structured interview. The quantitative data were examined using univariate analysis and the qualitative interview data were analysed using content analysis.
The survey was completed by 154 patients and eight of them were interviewed. Perceived efficacy in patient-physician interactions was the only variable that showed a significant difference between patients with and without an interest in support from a patient coach. The interviews revealed that a bad communication experience was the main reason for having an interest in support from a patient coach. Before the consultation, a patient coach should take the time to get to know the patient, build trust, and help the patient create an agenda, so take the patient seriously and recognize the patient as a whole person. During the consultation, a patient coach should support the patient by intervening and mediating when necessary to elicit the patient's agenda. After the consultation, a patient coach should be able to explain and discuss medical information and treatment consequences. An ideal patient coach should have medical knowledge, a strong personality and good communication skills.
Especially patients who had a bad communication experience in a specialist consultation would like support from a patient coach. The kind of support they valued most was intervening and mediating during the consultation. To build the necessary trust, patient coaches should take time to get to know the patient and take the patient seriously. Medical knowledge, good communication skills and a strong personality were considered prerequisites for patient coaches to be capable to intervene in specialist consultations.
对于一些患者来说，在专科医生就诊时进行有效的沟通是困难的。这些患者可以从陪同他们去看专科医生和在就诊期间提供支持的教练那里受益，以改善诊室中的沟通。本研究旨在调查患者对教练支持的兴趣，他们希望得到什么样的支持，以及理想的教练有哪些特点。
我们采用混合方法设计，以真实了解患者对教练的看法。在门诊候诊室的患者被要求填写一份简短的问卷，其中包括关于人口统计学特征、对医患互动的感知效力以及对教练支持的兴趣等问题。随后，对有兴趣接受教练支持的患者进行半结构化访谈。使用单变量分析对定量数据进行检验，对定性访谈数据进行内容分析。
共有 154 名患者完成了调查，其中 8 名患者接受了访谈。在医患互动中的感知效力是对教练支持感兴趣和不感兴趣的患者之间唯一有显著差异的变量。访谈显示，不良的沟通体验是对教练支持感兴趣的主要原因。在就诊前，教练应该花时间了解患者、建立信任，并帮助患者制定议程，从而认真对待患者并将其视为完整的人。在就诊期间，教练应在必要时进行干预和调解，以引出患者的议程。就诊后，教练应能够解释和讨论医疗信息和治疗后果。理想的教练应该具备医学知识、坚强的个性和良好的沟通技巧。
特别是在专科就诊时沟通体验不佳的患者，希望得到教练的支持。他们最看重的支持是在就诊期间进行干预和调解。为了建立必要的信任，教练应该花时间了解患者并认真对待患者。医学知识、良好的沟通技巧和坚强的个性被认为是教练能够干预专科就诊的前提条件。
