Patient-Centered Communication in Primary Care: Physician and Patient Gender and Gender Concordance
Patient-Centered Communication in Primary Care: Physician and Patient Gender and Gender Concordance
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DOI：
10.1089/jwh.2008.0969
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发表时间：
2009-04-01
影响因子：
3.5
通讯作者：
Epstein, Ronald M.
中科院分区：
文献类型：
--
作者：
Bertakis, Klea D.;Franks, Peter;Epstein, Ronald M.
背景：医生对以病人为中心的沟通（PCC）的使用影响了护理的重要结果。虽然有证据表明，病人和医生的性别影响的过程中的照顾，有有限的信息，他们对PCC的影响。我们的目的是调查患者和医生的性别，以及患者和医生之间的性别一致性的影响，对以患者为中心的初级保健visits.Methods：参与初级保健医生（100名家庭医生和内科医生）与临床实践的罗切斯特，纽约地区，有两个秘密秘密录音标准化的患者的访问。接触进行了分析，使用的措施，以病人为中心的沟通（MPCC），衡量三个方面的医生沟通：组件1（探索疾病和疾病的经验），组件2（了解整个人），组件3（寻找共同点）。而女性医生表现出较高的组件1的分数，男性医生有较高的组件2的分数，和性别一致的访问也表现出较高的组件2的分数。然而，有没有显着差异，在总MPCC分数为女性与男性医生或性别一致的遭遇与不一致的病人-医生dyads.Conclusions：这些研究结果增加了进一步的证据表明，病人的性别可以影响医生和病人之间的互动。需要更多的研究来了解为什么男性患者不太可能有医疗接触，他们的医生采用以患者为中心的实践风格。
Background: Physicians' use of patient-centered communication (PCC) affects important outcomes of care. Although there is evidence that both patient and physician gender affect the process of care, there is limited information about their impact on PCC. Our objective was to investigate the influence of patient and physician gender, as well as gender concordance between patient and physician, on the patient centeredness of primary care visits.Methods: Participating primary care physicians (100 family physicians and internists) with clinical practices in the Rochester, New York area, had two unannounced covertly audiorecorded standardized patients' visits. Encounters were analyzed using the Measure of Patient-Centered Communication (MPCC), which measures three aspects of physician communication: Component 1 (Exploring both the disease and illness experience), Component 2 (Understanding the whole person), and Component 3 (Finding common ground).Results: Compared with male patients, females had interactions characterized by greater PCC (total and Component 2 scores). Whereas female physicians exhibited higher Component 1 scores, male physicians had higher Component 2 scores, and gender-concordant visits also exhibited higher Component 2 scores. However, there were no significant differences in total MPCC scores for encounters of female vs. male physicians or for gender-concordant compared with discordant patient-physician dyads.Conclusions: These findings add further evidence that patient gender can affect the interactions between physicians and patients. More research is needed to understand why male patients are less likely to have medical encounters in which their physicians employ a patient-centered practice style.