Cecil D W, Killeen I
Communication and Journalism Department, University of New Mexico, Albuquerque, USA.
Fam Med. 1997 Oct;29(9):653-7.
With the current emphasis on patient-centered interviewing, issues of control behavior have become an important facet for understanding effective physician-patient communication. In this study, we describe how verbal control behaviors are manifested during the clinical encounter and how these control patterns relate to patient satisfaction and compliance.
Videotaped encounters (n = 50) in a family practice residency clinic were transcribed and analyzed using the Relational Communication Control Coding Scheme. In addition, we surveyed patients to assess levels of compliance and satisfaction.
Overall, patients showed assertive control patterns, and physicians manifested patterns of willingness to let patients take control of the conversation. The resulting outcomes showed that when physicians exhibited less control dominance, there was an increase in patient compliance and satisfaction.
The control patterns discovered are consistent with patient-centered viewpoints that encourage the patient's expression of ideas, concerns, and expectations. Increased levels of patient satisfaction and compliance were found when patients more assertively participated in the clinical conversation.
鉴于当前对以患者为中心的问诊的重视,控制行为问题已成为理解有效的医患沟通的一个重要方面。在本研究中,我们描述了言语控制行为在临床诊疗过程中的表现方式,以及这些控制模式与患者满意度和依从性之间的关系。
对一家家庭医学住院医师诊所的50次诊疗录像进行转录,并使用关系沟通控制编码方案进行分析。此外,我们对患者进行了调查,以评估依从性和满意度水平。
总体而言,患者表现出自信的控制模式,而医生则表现出愿意让患者主导谈话的模式。结果显示,当医生表现出较少的控制主导时,患者的依从性和满意度会提高。
所发现的控制模式与以患者为中心的观点一致,即以患者为中心的观点鼓励患者表达想法、担忧和期望。当患者更自信地参与临床谈话时,患者满意度和依从性水平会提高。