THE ABILITY OF TRAINEE GENERAL-PRACTITIONERS TO IDENTIFY PSYCHOLOGICAL DISTRESS AMONG THEIR PATIENTS
THE ABILITY OF TRAINEE GENERAL-PRACTITIONERS TO IDENTIFY PSYCHOLOGICAL DISTRESS AMONG THEIR PATIENTS
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DOI：
10.1017/s0033291700038976
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发表时间：
1993-02-01
影响因子：
6.9
通讯作者：
FARAGHER, EB
中科院分区：
文献类型：
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作者：
GOLDBERG, DP;JENKINS, L;FARAGHER, EB
有人认为，一个全科医生的能力，使准确的评级的心理困扰，部分是由患者发出的提示，表明这种痛苦的速度。这项研究探讨了医生的行为会影响患者发出此类暗示的速度。对六名全科职业实习生的咨询进行了录像，其中三名是穷人，三名是情绪疾病的鉴定者。选择咨询，以便对每个受训者进行评估，访谈4名GHQ评分低的患者和4名GHQ评分高的患者。行为的描述，导致增加的线索排放，也更频繁地实行能够标识符，而其他行为减少线索排放，并实行不太频繁。另一组行为在有能力的识别者中并不更频繁，但当有能力的识别者练习时，与患者的提示发射增加有关，而当有能力的识别者练习时，提示发射不变或减少。“病人主导”的访谈与提示发射率增加有关，而“医生主导”的访谈则与较低的比率有关。这些研究结果的影响，培训医生在一般医疗环境进行了讨论。
It is argued that a general practitioner's ability to make accurate ratings of psychological distress is partly determined by the rate at which patients emit cues that are indicative of such distress. This study addresses the behaviours of doctors which influence the rates at which patients emit such cues. Consultations were videotaped involving six General Practice Vocational Trainees, three of them poor, and three of them able identifiers of emotional illness. Consultations were selected so that each trainee was rated interviewing 4 patients with low GHQ scores, and 4 patients with high scores. Behaviours are described which lead to increased cue emission and which are also practised more frequently by able identifiers, while other behaviours reduce cue emission and are practised less frequently by them. Another set of behaviours is no more frequent among the able identifiers, but when practised by able identifiers is associated with increased cue emission by the patients, and when practised by poor identifiers with unaltered or decreased cue emission. Interviews that are 'patient-led' are associated with increased rates of cue emission, while those that are 'doctor-led' are associated with lower rates. The implications of these findings for training doctors working in general medical settings are discussed.