Bartlett E E, Grayson M, Barker R, Levine D M, Golden A, Libber S
J Chronic Dis. 1984;37(9-10):755-64. doi: 10.1016/0021-9681(84)90044-4.
An understanding of means to improve patient adherence to the therapeutic regimen is a subject of increasing concern in medical care. This study examined the effects of physician interpersonal skills and teaching on patient satisfaction, recall, and adherence to the regimen. We studied the ambulatory visits of 63 patients to five medical residents at a teaching hospital in Baltimore. It was found that quality of interpersonal skills influenced patient outcomes more than quantity of teaching and instruction. Secondary analyses found that all the effects of physician communication skills on patient adherence are mediated by patient satisfaction and recall. These findings indicate that the physician might pay particular attention to these two variables in trying to improve patient adherence, and that enhancing patient satisfaction may be pivotal to the care of patients with chronic illness.
了解提高患者对治疗方案依从性的方法是医疗保健领域日益受到关注的一个主题。本研究考察了医生的人际沟通技巧和指导对患者满意度、记忆力以及对治疗方案的依从性的影响。我们研究了巴尔的摩一家教学医院的63名患者对五位住院医师的门诊就诊情况。结果发现,人际沟通技巧的质量比教学和指导的数量对患者的治疗效果影响更大。二次分析发现,医生沟通技巧对患者依从性的所有影响都是通过患者满意度和记忆力来介导的。这些发现表明,医生在试图提高患者依从性时可能需要特别关注这两个变量,而且提高患者满意度可能是慢性病患者护理的关键。