摘要
目的采用循证医学文献质量评价方法,寻找医患沟通系统评价证据,为建立我国医患有效沟通模式提供依据。方法全面检索与医患关系和沟通交流主题相关的中英文系统评价或Meta分析相关文献,并追索参考文献及其索引,检索时间截至2008年3月30日。由两名评价员独立筛查文献,根据系统评价量表(OQAQ)对纳入文献质量进行再评价,如遇分歧讨论解决。结果共纳入与医患沟通相关的系统评价17篇,OQAQ量表评分,最高9分,最低为3分,其中9个条目平均符合率为66.01%(中位数为6),7～9分段占41.29%(7/17),6分占23.5%(4/17),3～5分段占35.3%(6/17)。影响医患沟通的主要因素有沟通对象、沟通时间、内容、方式等。沟通策略包括以不同模板分别对病人行为进行引导和对医护沟通技能进行针对性培训等。结论现有关于医患沟通的系统评价主要基于欧美国家,这反映出我国相关研究不足。基于现有证据,目前应建立鼓励沟通机制和文化,主动发现医患沟通问题和阻断不良沟通行为,同时关注病人意愿,合理选择培训策略,及时评估反馈,以提高医患沟通满意度。
Objective To seek the best evidence on communication between physicians and patients so as to improve the physician-patient relationship in China. Methods We used the key words ‘physician-patient relationship＇ and ‘communication＇ to identify related systematic reviews and meta-analyses, and then evaluated them with the Overview Quality Assessment Questionnaire （OQAQ） checklist. Results Seventeen studies were included for final evaluation. According to the OQAQ checklist, the score range of the study quality was 3 to 9. 41.29% （7/17） of the included studies scored 7 to 9, 23.5% （4/17） scored 6, and 35.3% （6/17） scored 3 to 5. Factors influencing physician-patient communication primarily included communication targets, time, contents, and approaches. Conclusion There are not enough studies on physician-patient communication in China. We need to identify the problems affecting communication behavior, encourage patients to express their preferences, choose appropriate training strategies, and make timely evaluation so as to better satisfy the needs of patients and physicians.
出处
《中国循证医学杂志》
CSCD
2008年第12期1100-1104,共5页
Chinese Journal of Evidence-based Medicine
关键词
医患沟通
医患关系
循证医学
系统评价
Physician-patient communication
Physician-patient relation
Evidence-based medicine
Systematic review
