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探索医患沟通的关键要素:一项关于外行和专业人士观点的定性研究

Exploring Critical Components of Physician-Patient Communication: A Qualitative Study of Lay and Professional Perspectives.

作者信息

Mohd Salim Nurul Ain, Roslan Nurhanis Syazni, Hod Rafidah, Zakaria Syahiera Farhana, Adam Siti Khadijah

机构信息

Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Malaysia.

Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia.

出版信息

Healthcare (Basel). 2023 Jan 5;11(2):162. doi: 10.3390/healthcare11020162.

Abstract

(1) Background: The ability to communicate with patients and their relatives is a crucial skill for a physician. Unfortunately, many physicians and medical students are not well-equipped in this area. Therefore, this study aims to better understand the views on critical components of physician-patient communication to improve their skills. (2) Methods: This qualitative study utilized focus group discussions (FGDs) and in-depth interviews (IDIs). Through a purposive sampling technique, 32 medical students and physicians from the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (FMHS UPM) and Universiti Putra Malaysia Teaching Hospital (HPUPM), as well as patients and relatives from government and private hospitals or clinics were recruited. All sessions were audio-recorded, transcribed, and analyzed thematically. (3) Results: Seven themes were identified: professionalism, content of communication, verbal, non-verbal and paraverbal communication skills, environment, and visual communication. Good eye contact, providing treatment plans, and ensuring patient privacy and confidentiality were emphasized by physicians and medical students. In comparison, patients and relatives focused on the prognosis of disease, physician's empathy and advice, and physician's skills in building rapport with their patients and relatives. (4) Conclusion: The critical components that were highlighted by both professionals and laymen in the study should be practiced to ensure effective communication between physician and patient. There were different expectations in terms of the content of information between both groups. Patients and relatives were more interested in the physician's advice regarding their diet, care plans, physical activities, and daily routine. They were also focused on the prognosis of the disease, which indicates how quickly they would get better. Meanwhile, physicians and medical students were concentrating on management and treatment strategies, such as what additional procedures should be considered and what medications might work best for their patients. We also found that the patients and relatives had a lack of awareness on confidentiality issues. These findings provide an insight on the improvement of medical training and patient education to improve patient care. Patients have a right to privacy protection, and physicians should be well trained to carry out all procedures and treatment plans to ensure patients are treated with respect.

摘要

(1)背景:与患者及其亲属沟通的能力是医生的一项关键技能。不幸的是,许多医生和医学生在这方面准备不足。因此,本研究旨在更好地了解对医患沟通关键要素的看法,以提高他们的技能。(2)方法:本定性研究采用焦点小组讨论(FGD)和深入访谈(IDI)。通过目的抽样技术,招募了来自马来西亚博特拉大学医学与健康科学学院(FMHS UPM)和马来西亚博特拉大学教学医院(HPUPM)的32名医学生和医生,以及来自政府和私立医院或诊所的患者及其亲属。所有会议都进行了录音、转录并进行了主题分析。(3)结果:确定了七个主题:专业素养、沟通内容、言语、非言语和辅助言语沟通技巧、环境以及视觉沟通。医生和医学生强调了良好的眼神交流、提供治疗方案以及确保患者隐私和保密。相比之下,患者及其亲属关注疾病的预后、医生的同理心和建议,以及医生与患者及其亲属建立融洽关系的技巧。(4)结论:本研究中专业人员和外行人都强调的关键要素应加以实践,以确保医患之间的有效沟通。两组在信息内容方面存在不同期望。患者及其亲属对医生关于饮食、护理计划、体育活动和日常生活的建议更感兴趣。他们还关注疾病的预后,这表明他们康复的速度有多快。与此同时,医生和医学生专注于管理和治疗策略,例如应考虑哪些额外的程序以及哪些药物可能对他们的患者最有效。我们还发现患者及其亲属对保密问题缺乏认识。这些发现为改进医学培训和患者教育以改善患者护理提供了见解。患者有权受到隐私保护,医生应接受良好培训以实施所有程序和治疗计划,以确保患者得到尊重。

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