Del Piccolo L
Servizio di Psicologia Medica, Università di Verona.
Epidemiol Psichiatr Soc. 1998 Jan-Apr;7(1):52-67. doi: 10.1017/s1121189x00007120.
The medical interview has important diagnostic and therapeutic functions and requires the integration of doctor-centred and patient-centred interviewing techniques to collect accurate and complete biopsychosocial data from the patient. Analysis of the interaction between patient and doctors which occur during the medical interview allow to evaluate physicians' interview techniques and to eventually improve them.
Previous reviews on interaction and keywords for Medline research (HealthGate) listed above were utilised to collect the relevant literature.
Seventeen classification systems were identified and ten were discussed in a chronological order. Starting from a general sociological or psycholinguistic approach, the IASs over the years have became more specific and detailed, focusing more on the medical interview and on specific topics, such as cancer or hospital medical consultations.
When studying interactions in general practice medicine, it is important to define the significant units of interaction which allow to identify a "patient-centred approach", since this is relevant not only for obtaining reliable and complete medical and social data, but also for the recognition of patients with emotional disorders and their correct diagnosis. Listening to the patient and facilitating the expression of emotions is an important aspect of patient education too, as patients learn that talking about psychological problems to their physician is appropriate and may be therapeutic.
医学问诊具有重要的诊断和治疗功能,需要结合以医生为中心和以患者为中心的问诊技巧,以便从患者那里收集准确和完整的生物心理社会数据。对医学问诊过程中患者与医生之间的互动进行分析,有助于评估医生的问诊技巧并最终加以改进。
利用上述关于互动的既往综述以及Medline研究(HealthGate)的关键词来收集相关文献。
共识别出17种分类系统,并按时间顺序讨论了其中10种。从一般社会学或心理语言学方法出发,多年来IAS变得更加具体和详细,更多地关注医学问诊以及特定主题,如癌症或医院医疗会诊。
在研究全科医学中的互动时,定义重要的互动单元很重要,这些单元有助于识别“以患者为中心的方法”,因为这不仅与获取可靠和完整的医学及社会数据相关,还与识别有情绪障碍的患者及其正确诊断相关。倾听患者并促进其情绪表达也是患者教育的一个重要方面,因为患者了解到向医生谈论心理问题是合适的且可能具有治疗作用。