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患者对远程医疗中医师沟通技巧的看法:孟加拉国样本中沟通评估工具的验证

Patients' views on physicians' communication skills in telemedicine: Validation of Communication Assessment Tool among Bangladeshi sample.

作者信息

Aminul Islam Mohammad, Hasan Tanvir, Mostari Shabnam, Joarder Taufique

机构信息

Department of Media Studies and Journalism, University of Liberal Arts Bangladesh (ULAB), Dhaka, Bangladesh.

BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.

出版信息

J Commun Healthc. 2025 Jul;18(2):102-111. doi: 10.1080/17538068.2024.2438474. Epub 2024 Dec 10.

Abstract

BACKGROUND

Technological advancement has added new dimensions to the communication between physicians and their patients in healthcare settings worldwide. This study aimed to measure patients' views about physicians' interpersonal communication during telemedicine consultations by cultural adaptation and validation of the communication assessment tool (CAT) in Bangladesh.

METHODS

A cross-sectional phone survey was conducted among 400 patients who received healthcare services from a telemedicine centre in Bangladesh. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the dimensionality of the CAT-Bangla scale. The goodness of fit of the CFA was assessed using the comparative fit index (CFI), Tucker-Lewis index (TLI), Chi-square values, root-mean-square error of approximation (RMSEA) and standardized root mean squared residual (SRMR). The internal consistency reliability of the CAT-Bangla scale was assessed using Cronbach's alpha.

RESULTS

Factor analysis findings suggest that the CAT-Bangla scale is unidimensional with good internal consistency (Cronbach's α = 0.876). The individual item analysis findings suggest that most of the patients felt that the physicians treated them with respect (81% rated 'excellent') and allowed them to talk without interruption (73.5% rated 'excellent'). Overall, the level of satisfaction among patients regarding physicians' communication skills was high with a mean score of 4.36 (SD = 0.30) across all the 14 items. However, the patients were not satisfied with the amount of time that physicians spent with them as none of them reported 'excellent' in that domain.

CONCLUSION

The CAT-Bangla scale is feasible, valid, and internally consistent for measuring physicians' communication skills in the telemedicine environment. This study can contribute to policymakers regarding the integration of learning communication skills of future physicians to competently deliver healthcare in the telemedicine environment. It would also help to understand various aspects of doctor-patient communication in a telemedicine context.

摘要

背景

技术进步为全球医疗环境中医护人员与患者之间的沟通增添了新的维度。本研究旨在通过对孟加拉国沟通评估工具(CAT)进行文化调适和验证,来衡量患者对远程医疗咨询期间医护人员人际沟通的看法。

方法

对400名从孟加拉国一家远程医疗中心接受医疗服务的患者进行了横断面电话调查。进行探索性因子分析(EFA)和验证性因子分析(CFA)以检验CAT-孟加拉语量表的维度。使用比较拟合指数(CFI)、塔克-刘易斯指数(TLI)、卡方值、近似均方根误差(RMSEA)和标准化均方根残差(SRMR)评估CFA的拟合优度。使用克朗巴赫α系数评估CAT-孟加拉语量表的内部一致性信度。

结果

因子分析结果表明,CAT-孟加拉语量表是单维度的,具有良好的内部一致性(克朗巴赫α系数=0.876)。单项分析结果表明,大多数患者认为医护人员尊重他们(81%评为“优秀”),并允许他们不受干扰地交谈(73.5%评为“优秀”)。总体而言,患者对医护人员沟通技巧的满意度较高,所有14个项目的平均得分为4.36(标准差=0.30)。然而,患者对医护人员与他们相处的时间不满意,因为在这方面没有人评为“优秀”。

结论

CAT-孟加拉语量表在测量远程医疗环境中医护人员的沟通技巧方面是可行、有效且内部一致的。本研究可为政策制定者在将未来医护人员的沟通技巧学习融入远程医疗环境中以胜任地提供医疗服务方面提供参考。它也将有助于理解远程医疗背景下医患沟通的各个方面。

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