Stivers Tanya, Tate Alexandra
Department of Sociology, University of California, Los Angeles, California, USA.
Department of Medicine, University of Chicago, Chicago, Illinois, USA.
Annu Rev Linguist. 2023 Jan;9:233-252. doi: 10.1146/annurev-linguistics-030521-054400. Epub 2022 Oct 7.
The physician-patient relationship has evolved significantly in the past century. Physician authority has been reduced while patients have been empowered. This review focuses on face-to-face clinical care and argues that current physician-patient relations range from partnerships between social actors who each play critical roles in negotiating care to a more adversarial duel in which both participants advocate for goals that are not necessarily shared. While the former is the hope of increased patient involvement, the latter is increasingly common. Through our discussion of existing studies, we document that while high levels of patient participation are beneficial to treatment outcomes, this engagement also has a dark side that threatens treatment outcomes. We discuss some communication resources patients use that affect treatment outcomes, exemplify how patient engagement affects physician communication, and discuss some strategies that current research finds effective for communicating about treatment with today's engaged patients.
在过去的一个世纪里，医患关系发生了显著的演变。医生的权威有所下降，而患者则获得了更多权力。本综述聚焦于面对面的临床护理，并认为当前的医患关系范围广泛，从在协商护理中各自发挥关键作用的社会行为者之间的伙伴关系，到一种更具对抗性的较量，即双方参与者都在倡导不一定相同的目标。虽然前者是增加患者参与度的期望，但后者却越来越普遍。通过对现有研究的讨论，我们记录到，虽然高水平的患者参与对治疗结果有益，但这种参与也有其阴暗面，会威胁到治疗结果。我们讨论了患者使用的一些影响治疗结果的沟通资源，举例说明了患者参与如何影响医生的沟通，并讨论了当前研究发现的一些与如今积极参与的患者进行治疗沟通的有效策略。
