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当医疗咨询并非面对面进行时:2019冠状病毒病期间以患者为中心的护理沟通的一项试点研究。

When medical consultations are not face-to-face: a pilot study of patient-centred care communication during coronavirus disease 2019.

作者信息

Li Biyun, Watson Bernadette, Yung Amos

机构信息

Department of English and Communication, The Hong Kong Polytechnic University, Hong Kong, China.

School of Professional and Continuing Education, The University of Hong Kong, Hong Kong, China.

出版信息

Mhealth. 2025 Mar 4;11:14. doi: 10.21037/mhealth-24-59. eCollection 2025.

Abstract

BACKGROUND

Patient-centred care (PCC) is essential to quality medical consultation. PCC communication refers to how PCC principles are reflected in doctor-patient interactions. Research has shown that a doctor's ability to communicate in a patient-centred manner is positively linked to patient satisfaction and improved health outcomes. However, previous studies have focused mainly on face-to-face communication and less is known about patient perceptions of PCC when medical interactions are not face-to-face such as online medical consultations (OMCs). This pilot study aims to explore patients' perceptions and experiences of OMCs.

METHODS

Participants were recent university graduates from mainland China. Sixty-three participants completed an online questionnaire designed to gauge PCC communication, which included four validated communication measures: (I) patient health willingness to communicate (HWTC); (II) doctors' consultation and relational empathy (CARE); (III) patient perceptions of participation in health consultation (PPP); and (IV) doctors' communication assessment tool (CAST). Participants provided their modality preference when using OMCs. To gain a deeper understanding of quantitative data, two supplementary open-ended questions were included where participants provided feedback on their preferences for using OMCs and discussed the advantages and disadvantages of OMCs.

RESULTS

Correlational analysis indicated that participants' perceptions of doctors' interpersonal and communication skills significantly correlated with perceived CARE (r=0.813, P<0.01) and with patient participation in health consultations (r=0.632, P<0.01). Supporting the quantitative results, the qualitative findings revealed that while participants appreciated the convenience of OMCs, they also felt that emotional care from doctors was lacking in the online format. Specifically, participants noted that nonverbal cues, rapport building, and other relational aspects were missing, which aligns with the quantitative data linking perceived doctor communication and empathy to patient satisfaction.

CONCLUSIONS

The findings suggest that more emphasis should be placed on training doctors to practice PCC communication in OMCs especially when the interactions are text-based. The results highlight that consideration must also be given to the interpersonal and emotional aspects of care that contribute to patient satisfaction with OMCs. Overall, this pilot study reinforces that PCC communication remains integral to quality medical interactions, regardless of whether they occur face-to-face or through an online format.

摘要

背景

以患者为中心的医疗服务(PCC)对于高质量的医疗咨询至关重要。PCC沟通是指PCC原则在医患互动中的体现方式。研究表明,医生以患者为中心进行沟通的能力与患者满意度及改善的健康结果呈正相关。然而,以往的研究主要集中在面对面沟通上,对于非面对面的医疗互动(如在线医疗咨询,OMC)中患者对PCC的看法了解较少。这项试点研究旨在探索患者对OMC的看法和体验。

方法

参与者是来自中国大陆的应届大学毕业生。63名参与者完成了一份旨在评估PCC沟通的在线问卷,其中包括四项经过验证的沟通指标:(I)患者健康沟通意愿(HWTC);(II)医生的咨询和关系同理心(CARE);(III)患者对参与健康咨询的看法(PPP);以及(IV)医生沟通评估工具(CAST)。参与者提供了使用OMC时的方式偏好。为更深入了解定量数据,还包括两个补充性的开放式问题,参与者在其中提供了关于使用OMC偏好的反馈,并讨论了OMC的优缺点。

结果

相关性分析表明,参与者对医生人际和沟通技巧的看法与感知到的CARE(r = 0.813,P < 0.01)以及患者参与健康咨询(r = 0.632,P < 0.01)显著相关。定性研究结果支持了定量结果,显示虽然参与者赞赏OMC的便利性,但他们也觉得在线形式缺乏医生的情感关怀。具体而言,参与者指出缺少非语言线索、建立融洽关系及其他关系方面的内容,这与将感知到的医生沟通和同理心与患者满意度联系起来的定量数据一致。

结论

研究结果表明,应更加重视培训医生在OMC中进行PCC沟通,特别是在基于文本的互动中。结果突出表明,还必须考虑有助于患者对OMC满意度的护理人际和情感方面。总体而言,这项试点研究强化了PCC沟通对于高质量医疗互动仍然不可或缺,无论其是面对面进行还是通过在线形式。

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