Croft C A, Asmussen L
Division of Child and Adolescent Research, American Academy of Pediatrics, Elk Grove Village, Illinois.
J Adolesc Health. 1993 Mar;14(2):109-14. doi: 10.1016/1054-139x(93)90094-6.
Medical professionals are increasingly expected to address issues of sexuality and acquired immunodeficiency syndrome (AIDS) with young patients and their parents. Focus group interviews were conducted with parents (n = 43) and adolescents (n = 800) to determine the preferred physician role regarding families and sexual development. Parents believed that a physician was an appropriate expert to assist in preventing negative risk behaviors (e.g., drugs, alcohol, sexual intercourse) and emphasized the importance of the physician developing a comfortable relationship early on with parents and youth to allow for reciprocal dialogue about sensitive topics. Parents also commented that physicians generally appeared uncomfortable when discussing personal issues (viz., sexuality) and frequently lacked communication skills (e.g., use of open-ended questions or statements) to foster conversation. Youth identified physicians as a logical source of information about sexuality but felt hesitant to ask questions that might prompt value-based discussion. Youth also expressed concern about confidentiality in the doctor-patient relationship. Adolescents desired physicians to be more "askable" than they are perceived to be. Guidelines are offered for strengthening office interactions and improving communication skills.
现在越来越期望医学专业人员与年轻患者及其父母探讨性取向和后天免疫机能丧失综合症(艾滋病)问题。对43位家长和800名青少年进行了焦点小组访谈,以确定医生在涉及家庭和性发育方面应扮演的理想角色。家长们认为医生是帮助预防负面风险行为(如吸毒、酗酒、性交)的合适专家,并强调医生尽早与家长和青少年建立融洽关系以便就敏感话题进行双向对话的重要性。家长们还评论说,医生在讨论个人问题(即性取向)时通常显得不自在,而且常常缺乏促进交流的沟通技巧(如使用开放式问题或陈述)。青少年认为医生是性取向信息的合理来源,但对于可能引发基于价值观讨论的问题提问时会感到犹豫。青少年还对医患关系中的保密问题表示担忧。青少年希望医生比他们目前给人的感觉更“值得问询”。本文提供了加强诊室互动及提高沟通技巧的指导方针。