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考察心脏病学诊疗中临床医生沟通与患者参与行为之间的关系。

Examining the relationship between clinician communication and patient participatory behaviors in cardiology encounters.

机构信息

Duke University School of Medicine, Durham, USA.

Department of Pediatrics, Duke University School of Medicine, Durham, USA.

出版信息

Patient Educ Couns. 2022 Dec;105(12):3473-3478. doi: 10.1016/j.pec.2022.09.010. Epub 2022 Sep 15.

Abstract

OBJECTIVES

Examine the association of coder ratings of cardiologist behaviors and global scores of cardiologist communication style with patient participation in clinic encounters.

METHODS

We coded transcripts of clinic encounters for patient participatory behaviors: asking questions, assertive statements, and expressing negative emotions; clinician behavior counts: reflective statements, open-ended questions, empathic statements, and eliciting questions. We used general linear regression models to examine associations of mean number of patient participatory behaviors with clinician behaviors.

RESULTS

Our sample included 161 patients of 40 cardiologists. Patient female gender was associated with on average 2.1 (CI: 0.06, 4.1; p = 0.04) more patient participatory behaviors. In an adjusted model, clinician reflective statements were associated with on average 0.3 (CI: 0.04, 0.4; p = 0.02) more patient participatory behaviors. A clinician making at least one empathic statement was associated with on average 3.7 (CI: 0.2, 7.1; p = 0.04) more patient participatory behaviors.

CONCLUSIONS

These results demonstrate that some individual clinician behaviors are associated with higher patient participation in cardiology encounters.

PRACTICE IMPLICATIONS

Clinician reflective and empathic statements may be important targets in communication training to increase patient participation.

SECTION

Communication Studies.

摘要

目的

考察心脏病专家行为的编码评分与心脏病专家沟通方式的整体评分与患者在就诊过程中参与程度的相关性。

方法

我们对就诊过程中的患者参与行为(提问、坚定陈述和表达负面情绪)和临床医生行为(反映性陈述、开放式问题、共情陈述和提问)进行了转录编码。我们使用了一般线性回归模型来考察患者参与行为的平均数量与临床医生行为之间的关联。

结果

我们的样本包括 40 位心脏病专家的 161 位患者。女性患者平均表现出 2.1 个(CI:0.06,4.1;p=0.04)更多的患者参与行为。在调整后的模型中,临床医生的反映性陈述与平均 0.3 个(CI:0.04,0.4;p=0.02)更多的患者参与行为相关。至少发表一次共情陈述的临床医生与平均 3.7 个(CI:0.2,7.1;p=0.04)更多的患者参与行为相关。

结论

这些结果表明,一些临床医生的个体行为与患者在心脏病学就诊中的更高参与度相关。

实践意义

临床医生的反映性和共情性陈述可能是沟通培训中增加患者参与度的重要目标。

学科

传播研究。

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