【作者】 刘丽萍；

【导师】 冯涛；

【作者基本信息】 重庆医科大学 ， 社会医学与卫生事业管理， 2016， 硕士

【摘要】 背景:近年来,随着我国市场经济的发展和医疗体制的转变,医患关系日益紧张,原因涉及国情、体制、法制、政策、观念等各个方面。而在我国高等医学教育中,一直以来都忽视了对医学生沟通技能的培养。在医患矛盾突显的今天,加强对医学生医患沟通能力的培养意义重大,且势在必行。目的:通过调查医学实习生的临床沟通能力现状,发现其在临床沟通方面存在的问题,分析影响其临床沟通能力发展的关键因素,找出临床沟通能力的培养和教育中存在的问题,并针对问题提出建设性对策和建议,从而为我校医学本科生的临床沟通能力教学改革提出参考意见。方法:本研究设计了内容全面、结构合理的调查问卷。随机抽取重庆医科大学2010级临床医学专业本科实习生200名作为本次问卷的调查对象。运用统计学的调查方法,录入数据,使用SPSS软件对数据进行处理。分析实习生的性别、对医学的兴趣、成绩、性格以及是否受过临床沟通的系统培训等因素对实习生医患沟通行为的影响。结果:总体来说,女生的临床沟通能力比男生强,对医学有兴趣的医学生在医患沟通方面表现较好,成绩好的实习生临床沟通能力比较强,性格外向的实习生临床沟通行为评价比较高;受过临床沟通系统培训的实习生临床沟通能力较强。另外,患者对实习生的不信任以及新闻媒体的报道对实习生的临床沟通行为有影响。结论:医患关系不协调的原因涉及国情、体制、政策、舆论等各个方面,但在这些客观因素存在的情况下,医学院校应该制定明确的培养目标,采取切实可行的培养措施加强对医学生的临床沟通能力的培养,医学生自己必须学会沟通和处理医患关系的技能,提高医疗服务质量,这是成长为合格的临床医生不可缺少的条件,也是从我做起改善医患关系,减少医疗纠纷的重要途径。更多还原

【Abstract】 Background: In recent years, as the development of market economics and the changes of Health Care system, the relationship between doctors and patients becomes terrible; and the reasons include many aspects such as Current National conditions, Policies, Laws, social opinions and so on. At the Higher Medical Education System in China, the schools and professors just focused on the medical knowledge; but they ignored the way to communicate with the patients. So as the increasing number of the contradictions between doctors and patients, enhancing the Clinical Communication Abilities for the medical systems will be very important.Objective: To discover the problems of medical interns in clinical communication by investigating their present communcation situation; to find the problems in training of clinical communication and education through analyzing the key factors affecting their clinical communcation; and to put forward constructive countermeasures and suggestions, so as to provide reference suggestions for educational reform on clinical communication skills of undergraduates in our university.Methods: This study designed a comprehensive, scientific and reasonable questionnaire. A total of 200 undergraduate interns were randomly selected from clinical medical specialty of grade 2010 in Chongqing Medical University as research objects. Based on the statistical investigation method, statistical database was set, SPSS was used for data processing, to analyze the influences of various factors affecting the doctor-patient communication behavior of interns.Results: Generally, female students had better clinical communication skills than male students, students with greater interest in medicine did better in doctor-patient communication, interns with better scores had stronger clinical communication ability, and extroverted interns were well evaluated on their clinical communication; interns with systemic training on clinical communication had stronger communication ability. In addition, patients’ non-confidence on the interns, as well as the report of news media also had effects on clinical communication behavior of interns.Conclusion: The cause of the unharmonious relationship between doctors and patients involves many aspects, from national conditions, system, policy to public opinion, etc. However, in the presence of these objective factors, medical colleges and universities should take practical measures to strengthen the clinical communication skills of medical students, while medical students themselves must learn the skills to communicate and deal with the relationship and improve the quality of medical service. It is a necessary condition for medical students to become qualified clinicians, and is also an important way to improve doctor-patient relationship and reduce medical disputes.更多还原