【摘要】 目的比较内科住院医师和患者对医患沟通基本要素的价值取向,探究差异维度和相关因子,为教学提供参考。方法参考Kalamazoo共识声明中医患沟通各要素制定中文版等级量表,以随机抽样方式对内科住院医师和本地患者发放调查问卷各200份,分别收回有效答卷179份和156份。结果接受过培训的住院医师在"展开讨论"(3.82±0.70 vs 3.56±0.70,F=4.425,P=0.037)和"自我评价"(21.85±2.25 vs 12.05±2.51,F=3.905,P=0.050)维度优于未受训医师。"建立关系""理解观点""分享信息""达成共识"和"结束讨论"5个维度及总体方面,医患双方沟通价值取向均存在统计学差异(P<0.05)。多元线性回归分析提示,性别(P=0.046)、年龄(P<0.001)、专业背景(P<0.001)和受教育程度(P=0.005)是价值取向差异的重要相关因子。结论医患双方在沟通中存在明显的价值取向差异。为构建和谐医患关系,保障并促进全民健康,住院医师规范化培训不仅要重视沟通技能的日常培训,更应强化共情和以患者为中心的医学人文理念与实践。更多还原

【Abstract】 Objective This article aimed to compare the preferences and value-orientation of basic elements of doctor-patient communicatioii between patients and standardized training residents of internal medicine and,by exploring the dimensions of differences and related factors,provide some helpful references for the residency teaching and training.Methods A Chinese rating scale was developed based on the elements of doctor-patient comlunication in Kalamazoo consensus statement.With randomized sampling,179 standardized training residents of internal medicine and 156 local patients responded to the surveys.Results The trained residents scored higher than the untrained in dimensions of "opening the discussion"(3.82±0.70 vs 3.56±0.70,F=4.425,P=0.03 7) and " selfevaluation"(21.85±2.25 vs 12.05±2.51,F=3.905,P=0.050).In terms of dimension scores of "building relationships", "understanding the patient’s perspectives" "sharing information" "reaching agreement" and "providing closure",there were statistically significant differences in all these communcation value preferences between residents and patients(P<0.05).Multiple linear regression analysis suggested that gender(P=0.046),age(P<0.001),professional background(P<0.001) and education levels(P=0.005) were important correlation factors of different preferences.Conclusion Obvious differences exist in preferences of communication between doctors and patients.In order to establish a healthy doctor-patient relationship and Promote national well-beings,not only conummication skills training urgently is needed in standardized residency training,but the practice of empathy,patient-centered attitudes and medical humanities should be strengthened.更多还原