Lester G W, Smith S G
University of Saint Thomas, Houston, Texas.
West J Med. 1993 Mar;158(3):268-72.
This study evaluates the hypothesis that the way physicians communicate with patients and the degree patients perceive physician fault for bad medical outcomes are risk factors for the initiation of malpractice lawsuits. The study involved 160 adults who viewed a videotape of a physician treating a patient while using either positive or negative communication behaviors. Participants were told that the case had either a positive result, a bad result through no fault of the physician, a bad result for uncertain reasons, or a bad result that was the physician's fault. Participants then rated their litigious feelings. Results showed that the use of negative communication behaviors by the physician increased litigious intentions. An increased perception of physician fault for the bad result also increased litigious intentions. Uncertainty as to the reason for the bad outcome, however, raised litigious feelings nearly as much as did perceived physician fault. The results of the study support the hypothesis that altering the way physicians communicate and improving patient education can affect the risk of malpractice lawsuits.
医生与患者沟通的方式以及患者认为医生对不良医疗结果应承担过错的程度是引发医疗事故诉讼的风险因素。该研究涉及160名成年人，他们观看了一段医生治疗患者的录像带，录像中医生使用了积极或消极的沟通行为。参与者被告知该病例要么有积极结果，要么是在医生无过错的情况下出现了不良结果，要么是由于不确定原因导致了不良结果，要么是医生有过错导致了不良结果。然后，参与者对他们提起诉讼的意愿进行了评分。结果显示，医生使用消极沟通行为会增加提起诉讼的意图。对医生对不良结果的过错认知增加也会增加提起诉讼的意图。然而，不良结果原因的不确定性引发的诉讼意愿几乎与医生过错认知引发的一样多。该研究结果支持了以下假设：改变医生的沟通方式和加强患者教育可以影响医疗事故诉讼的风险。
