Sticks and stones: investigating rude, dismissive and aggressive communication between doctors
Sticks and stones: investigating rude, dismissive and aggressive communication between doctors
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DOI：
10.7861/clinmedicine.15-6-541
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发表时间：
2015-12-01
影响因子：
4.4
通讯作者：
Whitelaw, Benjamin C.
中科院分区：
文献类型：
--
作者：
Bradley, Victoria;Liddle, Samuel;Whitelaw, Benjamin C.
破坏性的沟通是NHS内部的一个问题;然而，以前的研究集中在欺凌上。医生之间的粗鲁、轻蔑和攻击性（RDA）沟通是一个更普遍的问题，而且调查不足。我们进行了一项混合方法研究，结合调查和焦点小组来描述医生之间的RDA沟通的程度，其背景和随后的影响。共有606名医生在英格兰的三家教学医院接受了调查。在一家教学医院与医生举行了两次结构化重点小组会议。31%的医生描述每周多次或更频繁地接受RDA沟通，初级和注册医生受影响的频率是顾问的两倍。粗鲁更常见于特定的专业：放射科，普通外科，神经外科和心脏科。40%的受访者表示RDA对他们的工作日有中度或严重影响。RDA沟通的背景被描述为五个主题：工作量，缺乏支持，患者安全，层次结构和文化。RDA通信的影响被描述为个人的，包括情绪困扰和药物滥用，和专业，包括去动力。医生之间的RDA沟通是一种普遍的破坏性行为，发生在医疗保健中常见的环境中。认识到对医生和潜在患者的影响是改变的关键。
Destructive communication is a problem within the NHS; however previous research has focused on bullying. Rude, dismissive and aggressive (RDA) communication between doctors is a more widespread problem and underinvestigated. We conducted a mixed method study combining a survey and focus groups to describe the extent of RDA communication between doctors, its context and subsequent impact. In total, 606 doctors were surveyed across three teaching hospitals in England. Two structured focus groups were held with doctors at one teaching hospital. 31% of doctors described being subject to RDA communication multiple times per week or more often, with junior and registrar doctors affected twice as often as consultants. Rudeness was more commonly experienced from specific specialties: radiology, general surgery, neurosurgery and cardiology. 40% of respondents described that RDA moderately or severely affected their working day. The context for RDA communication was described in five themes: workload, lack of support, patient safety, hierarchy and culture. Impact of RDA communication was described as personal, including emotional distress and substance abuse, and professional, including demotivation. RDA communication between doctors is a widespread and damaging behaviour, occurring in contexts common in healthcare. Recognition of the impact on doctors and potentially patients is key to change.