【摘要】 目的 探讨社区未分化疾病咨询策略模型的构建与应用方法。方法 本文通过文献研究法构建一个适合社区门诊未分化疾病的咨询策略模型。通过两个典型案例，参与式观察真实情景中，患者需求的具体内容、表现形式和影响因素，以及通过该咨询策略达成共识的策略和方法。结果 策略模型：(1)明确问题。通过详细问诊，了解患者真实动机，明确需要解决的问题。(2)汇总分析。总结现有临床资料所反映的健康问题，说明理由。(3)回应期望。深入剖析患者的担忧与现有临床资料之间的关系，解释排除的依据。(4)共同决策。评估进一步检查或治疗的代价和潜在获益，权衡利弊，与患者就最终决策达成共识。案例分析：通过参与式观察，了解患者就医动机及其影响因素，运用该咨询策略达成医患共同决策，避免过度检查。结论 在社区未分化疾病的处理中，有效的咨询策略对提升患者满意度，避免过度诊疗，实现医患共同决策有积极意义。更多还原

【Abstract】 Objective To explore the construction and application methods of a community undifferentiated disease counseling strategy model. Methods This article constructs a consultation strategy model suitable for undifferentiated diseases in community clinics through literature research.Through two typical cases,participatory observation of the specific content,manifestations,and influencing factors of patient needs in real situations,as well as strategies and methods for reaching consensus through this counseling strategy. Results The strategy model:First,clarify the problem.Through detailed consultation,understand the patient’s true motivation and identify the issues that need to be addressed.Second,summary analysis.Summarize the health issues reflected by existing clinical data and explain the reasons.Third,respond to expectations.Thoroughly analyze the relationship between major diseases that patients are concerned about and existing clinical data,and explain the basis for exclusion.Forth,joint decision-making.Assess the costs and potential benefits of further examination or treatment,weigh the pros and cons,and reach a consensus with the patient on the final decision.Case analysis:Through participatory observation,understand the patient’s motivation to seek medical treatment and its influencing factors,and use this consulting strategy to achieve joint decision-making between doctors and patients,avoiding over examination. Conclusion In the management of undifferentiated diseases in the community,effective consultation strategies have positive significance in improving patient satisfaction,avoiding excessive diagnosis and treatment,and achieving joint decision-making between doctors and patients.更多还原