van den Brink-Muinen A, Bensing J M, Kerssens J J
NIVEL, Netherlands Institute of Primary Health Care, Utrecht, The Netherlands.
Med Care. 1998 Jan;36(1):100-6. doi: 10.1097/00005650-199801000-00012.
Differences were investigated between general practitioners providing women's health care (4 women) and general practitioners providing regular health care (8 women and 8 men). Expectations were formulated on the basis of the principles of women's health care and literature about gender differences.
Data were used from 405 videotaped consultations of female patients (over 15 years). Roter's Interaction Analysis System (RIAS) was used to measure the verbal affective and instrumental behavior of the doctors and their patients. These data were supplemented by various nonverbal measures. The data were analyzed by means of multilevel analysis.
Doctors in the women's health care practice (called Aletta) look at their patients and talk with them more than other doctors. The general practitioners have approximately the same affective behavior, but the Aletta doctors show more verbal attentiveness and warmth. They also give more medical information and advice. Most of the characteristics of Aletta doctors fit female doctors providing regular health care too. Male doctors show a less communicative behavior in most respects. The differences between general practitioners are reflected in their patients' communication style.
The integration into regular care of some aspects of doctor-patient communication that were found in women's health care might be desirable in the light of the further improvement of the quality of care for women and men.
对提供女性健康护理的全科医生（4名女性）和提供常规健康护理的全科医生（8名女性和8名男性）之间的差异进行调查。根据女性健康护理原则及有关性别差异的文献提出期望。
使用405例女性患者（15岁以上）的录像会诊数据。采用罗特互动分析系统（RIAS）测量医生及其患者的言语情感和工具性 行为。这些数据辅以各种非言语测量方法。通过多层次分析对数据进行分析。
提供女性健康护理的医生（称为阿莱塔）比其他医生更关注患者并与他们交谈。全科医生的情感行为大致相同，但阿莱塔医生表现出更多的言语专注和热情。他们也提供更多的医疗信息和建议。阿莱塔医生的大多数特征也适用于提供常规健康护理的女医生。大多数方面，男医生的沟通行为较少。全科医生之间的差异体现在他们患者的沟通方式上。
鉴于要进一步提高对男性和女性的护理质量，将女性健康护理中发现的医患沟通的某些方面融入常规护理可能是可取的。
