The role of empathy in establishing rapport in the consultation: a new model
The role of empathy in establishing rapport in the consultation: a new model
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DOI：
10.1111/j.1365-2923.2007.02789.x
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发表时间：
2007-07-01
影响因子：
6
通讯作者：
Walsh, Deirdre
中科院分区：
文献类型：
--
作者：
Norfolk, Tim;Birdi, Kamal;Walsh, Deirdre
上下文。最近对以病人为中心的咨询概念进行了大量研究。这种方法的主要目标是建立对病人对他或她的问题的观点的清晰理解，并允许这种理解告知咨询的解释和计划阶段。这种理解的质量在很大程度上取决于医生的移情准确性；方法：为了强调移情和沟通技巧在建立融洽关系中的作用，我们最初开发了一个模型，旨在将不同研究论文中确定的各种动机和技能元素纳入一个全面的模型，以实现医患之间的共同理解。然后，我们通过涉及全科医生（gp）和临床心理学家的定性分析对模型进行了初步验证。结果：验证为模型的主要要素提供了令人鼓舞的支持。结论：该模型似乎捕捉到了医患之间建立治疗关系（融洽关系）的动态过程，这种关系由医生对患者对其问题的看法的理解质量来定义。可以说，该模型最重要的贡献是强调了这样一个事实，即“同理心”和随之而来的“融洽关系”并不是神秘的或排他的概念，而是涉及到在某种程度上所有人都可以使用的特定技能。
Context.Considerable research has been conducted recently into the notion of patient-centred consulting. The primary goal of this approach is to establish a clear understanding of the patient's perspective on his or her problem, and to allow this understanding to inform both the explanation and planning stages of the consultation. The quality of this understanding is largely determined by the empathic accuracy achieved by the doctor; the primary benefit is a therapeutic rapport between doctor and patient.Methods.To highlight the role of empathy and communication skills in establishing rapport, we initially developed a model which seeks to draw the various motivational and skill elements identified in separate research papers into a comprehensive model of the journey towards shared understanding between doctor and patient. We then conducted an initial validation of the model via qualitative analysis involving general practitioners (GPs) and clinical psychologists.Results.The validation offered encouraging support for the principal elements of the model. Specific suggestions for clarification and extension were then incorporated in a revised model.Conclusions.The model appears to capture the dynamic process of establishing a therapeutic relationship (rapport) between doctor and patient, defined by the quality of the doctor's understanding of the patient's perspective on his or her problem. Arguably, the most important contribution of the model is to highlight the fact that 'empathy' and consequent 'rapport' are not mystical or exclusive concepts but, rather, involve the use of specific skills accessible at some level by all.