Hooper E M, Comstock L M, Goodwin J M, Goodwin J S
Med Care. 1982 Jun;20(6):630-8. doi: 10.1097/00005650-198206000-00009.
We examined whether four patient characteristics (age, ethnicity, sex and appearance) influenced five physician behaviors with the patient (interviewing, nonverbal attention, courtesy, information giving and empathy). Ten physician-patient interactions were observed through a one-way mirror for each of 15 physicians. Physicians were rated higher on information giving (p = 0.002) and empathic skills (p = 0.02) when they were with female patients; on interviewing (p = 0.02) and empathy (p = 0.0007) with Anglo-American compared with Spanish-American patients; on interviewing (p = 0.01), nonverbal attention (p = 0.001) and courtesy (p = 0.02) when with the best groomed patients; and on courtesy (p = 0.03) with elderly patients. In addition, there were fewer physician-initiated interruptions with female patients (p = 0.03) and with well-groomed patients (p = 0.02). Each of the four patient characteristics studied acted independently in influencing physician behavior. The recognition that patient characteristics influence physician behavior should stimulate physicians to examine their reactions in order to insure that all types of patients receive thorough, courteous and empathic care.
我们研究了患者的四个特征（年龄、种族、性别和外表）是否会影响医生与患者互动时的五种行为（问诊、非语言关注、礼貌、提供信息和同理心）。通过单向镜对15位医生与患者的互动进行观察，每位医生观察10次。结果发现，医生与女性患者互动时，在提供信息方面（p = 0.002）和同理心技巧方面（p = 0.02）得分更高；与英裔美国患者相比，在问诊方面（p = 0.02）和同理心方面（p = 0.0007）与西班牙裔美国患者互动时得分更高；与外表最整洁的患者互动时，在问诊方面（p = 0.01）、非语言关注方面（p = 0.001）和礼貌方面（p = 0.02）得分更高；与老年患者互动时，在礼貌方面（p = 0.03）得分更高。此外，医生主动打断女性患者（p = 0.03）和外表整洁的患者（p = 0.02）的次数较少。所研究的患者的四个特征在影响医生行为方面各自独立起作用。认识到患者特征会影响医生行为，应促使医生审视自己的反应，以确保所有类型的患者都能得到全面、礼貌和有同理心的护理。
