Siegrist J
Med Klin. 1976 Nov 5;71(45):1962-6.
The article tries to demonstrate on an empirical basis how physicians in hospitals react to threatening situations, namely the demand of information about illness by severely ill patients. Four types of reaction relating to physicians' verbal communications are distinguished and illustrated by tape-recordings on clinical visits:1. Disregard, 2. Shift of the topic or the addressee, 3. Communication of "reference-information", 4. Communication of "functional uncertainty". The results demonstrate that nonsymmetrical communications are significantly more usual in regard to severely ill than regard to non severe patients and significantly more usual among traditionally trained physicians than among physicians with psychosomatic or psychotherapeutic training or orientation. Some practical consequences are mentioned, especially in the field of medical education.
本文试图通过实证研究来证明医院中的医生如何应对威胁性情况，即重症患者对病情信息的需求。研究区分了与医生言语交流相关的四种反应类型，并通过临床问诊的录音进行了说明：1. 忽视；2. 转移话题或对象；3. 传达“参考信息”；4. 传达“功能不确定性”。结果表明，与非重症患者相比，与重症患者的交流中不对称交流明显更为常见；与接受过身心医学或心理治疗培训或有相关取向的医生相比，传统培训的医生之间的不对称交流明显更为常见。文中提到了一些实际影响，特别是在医学教育领域。
