Fry R P, Stones R W
Department of Mental Health Sciences, St. George's Hospital Medical School, London, UK.
Psychother Psychosom. 1996;65(5):253-7. doi: 10.1159/000289084.
Interaction in medical consultations is of interest for many reasons and has long been thought an important variable in determining outcomes. Relatively few methods or instruments exist that attempt to access this phenomenon. The design, validation and possible application of a simple instrument to assess doctor-patient interaction are reported. Rapport and hostility may be related and we hypothesised that interaction between doctor and patient would be related in part to hostility.
A simple instrument to assess doctor-patient interaction was designed based on 4 areas related to interaction and perception of 'the other'. These were the areas of communication, rapport, trust and sense of ease. The instrument was compared with an external previously validated measure of hostility. Data were obtained from 74 women attending initial and follow-up consultations for chronic pelvic pain during the course of a larger study.
The instrument had acceptable reliability and a single-factor structure. Patients' assessment of the initial consultation as unsatisfactory correlated with inwardly directed hostility (Spearman correlation coefficient, r = 0.30, p = 0.011). Patients' tendency to rate the consultation worse than the doctor was correlated with inwardly directed hostility (r = 0.42, p < 0.001). Pain outcomes were not directly related to the variables studied.
This instrument offers a simple method of assessing some interactional aspects of a medical consultation.
出于多种原因，医疗会诊中的互动备受关注，长期以来一直被认为是决定治疗结果的一个重要变量。但目前用于评估这一现象的方法和工具相对较少。本文报告了一种用于评估医患互动的简单工具的设计、验证及可能的应用。融洽关系和敌意可能相关，我们推测医患之间的互动部分与敌意有关。
基于与对“对方”的互动和认知相关的4个领域，设计了一种用于评估医患互动的简单工具。这4个领域分别是沟通、融洽关系、信任和自在感。将该工具与一种先前经过外部验证的敌意测量方法进行比较。数据来自一项更大规模研究中74名因慢性盆腔疼痛参加初次和后续会诊的女性。
该工具具有可接受的信度和单因素结构。患者将初次会诊评估为不满意与内向型敌意相关（斯皮尔曼相关系数，r = 0.30，p = 0.011）。患者给会诊评分低于医生的倾向与内向型敌意相关（r = 0.42，p < 0.001）。疼痛结局与所研究的变量无直接关系。
该工具提供了一种评估医疗会诊中某些互动方面的简单方法。
