Stewart M A, McWhinney I R, Buck C W
J R Coll Gen Pract. 1979 Feb;29(199):77-81.
The study of 299 chronically ill patients examined the doctor/patient relationship by asking two questions: first, what factors affect the quality of the relationship and secondly, does the doctor/patient relationship affect outcome for the patient? The doctor/patient relationship was measured by indicators of the doctor's awareness of the patient's problems.The following factors were found to be positively associated with the doctor's awareness: a small number of patient problems, a large number of recent visits, and the patient, rather than the doctor, initiating the consultation. The patient's age and education, the completeness of family care, and duration of care were not found to influence awareness. After eliminating the effect of confounding variables, the relationship between the doctor's awareness and the patient's recovery was maintained for some groups of patients. Awareness did not significantly affect the patient's satisfaction. We list some practical recommendations to aid doctors in increasing their knowledge of their patients.
对299名慢性病患者的研究通过两个问题考察了医患关系：第一，哪些因素会影响医患关系的质量；第二，医患关系是否会影响患者的治疗结果？医患关系通过医生对患者问题的认知指标来衡量。研究发现，以下因素与医生的认知呈正相关：患者问题数量少、近期就诊次数多以及由患者而非医生发起会诊。未发现患者的年龄和教育程度、家庭护理的完整性以及护理时长会影响医生的认知。在消除混杂变量的影响后，医生的认知与部分患者群体的康复之间的关系依然存在。认知对患者满意度没有显著影响。我们列出了一些实用建议，以帮助医生增加对患者的了解。
