Grüninger U J
Unit for Evaluation, Research and Continuing Education, Swiss Federal Office of Public Health, Liebefeld-Bern.
J Hum Hypertens. 1995 Jan;9(1):15-25.
One fourth of a physician's office time is used on average for giving information, instructing and counselling. Such patient education takes place mostly in a one-to-one situation where the physician helps his patients to understand and accept their illnesses, to recognise and acknowledge risk behaviours, to make informed treatment decisions, to develop treatment plans, and to cope with problems of maintenance and relapse. The physician must be able to communicate with his patient in a way that fosters the patient's learning and change processes, in order to maximise the medical outcomes and hence the efficacy and effectiveness of his work. Unfortunately the immense therapeutic potential of patient education is still underutilised, in spite of the fact that patient education has a clearly proven impact on health outcomes, such as reducing morbidity and mortality, reducing risk behaviors and risk factors, increasing healthy behaviour as well as patient and doctor satisfaction, and avoiding malpractice litigation. This paper reviews the principles of motivation and doctor-patient communication, presents current models of the patient's learning and change process, derives rules for effective educational communication, and methodological advice for the individual patient education session.
医生平均有四分之一的门诊时间用于提供信息、指导和咨询。这种患者教育大多在一对一的情况下进行，医生帮助患者了解和接受自己的病情，认识并承认危险行为，做出明智的治疗决策，制定治疗计划，以及应对维持治疗和复发问题。医生必须能够以促进患者学习和改变过程的方式与患者沟通，以便最大限度地提高医疗效果，从而提高其工作的效率和成效。不幸的是，尽管患者教育对健康结果有明确证实的影响，如降低发病率和死亡率、减少危险行为和危险因素、增加健康行为以及提高患者和医生的满意度，避免医疗事故诉讼，但患者教育的巨大治疗潜力仍未得到充分利用。本文回顾了动机和医患沟通的原则，介绍了当前患者学习和改变过程的模型，得出了有效教育沟通的规则，以及针对个别患者教育环节的方法建议。
