Interpersonal perception in the context of doctor-patient relationships: A dyadic analysis of doctor-patient communication
Interpersonal perception in the context of doctor-patient relationships: A dyadic analysis of doctor-patient communication
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DOI：
10.1016/j.socscimed.2009.10.065
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发表时间：
2010-03-01
影响因子：
5.4
通讯作者：
Campbell, Craig
中科院分区：
文献类型：
--
作者：
Kenny, David A.;Veldhuijzen, Wemke;Campbell, Craig
医患沟通是一个人际交往的过程，对以关系为中心的护理至关重要。然而，在许多研究中，医生和病人似乎生活在不同的世界。本研究评估：1)医生对自己沟通技巧的认知与患者的认知是否一致；2)某一特定医生的患者对其医生的沟通技巧意见一致。一项横断面研究在加拿大的三个省进行，共有91名医生和他们的1749名患者。医生和患者在会诊后独立完成关于医生沟通技巧（内容和过程）的问题。多层模型提供了患者和医生方差成分在二元水平和医生水平的估计。我们计算了患者和医生在这两个层面上的感知之间的相关性，以评估他们的一致性。使用类内相关系数（ICC）评估特定医生的患者共识。患者对医生技能的平均评分为4.58分，医生对医生技能的平均评分为4.37分。患者的双染色体水平方差为。38，医生是0.06。医生对病人评分的水平差异为。01分，医生组，0.18分。在二代水平上，病人和医生的技能评分之间的相关性很弱。在医生水平上，相关性无统计学意义。患者评分的ICC是。医生的评分是0.76。总的来说，这项研究表明，医生和他们的病人对医生在日常临床接触中发生的沟通技巧有非常不同的看法。2009爱思唯尔有限公司版权所有。
Doctor-patient communication is an interpersonal process and essential to relationship-centered care. However, in many studies, doctors and patients are studied as if living in separate worlds. This study assessed whether: 1) doctors' perception of their communication skills is congruent with their patients' perception; and 2) patients of a specific doctor agree with each other about their doctor's communication skills. A cross-sectional study was conducted in three provinces in Canada with 91 doctors and their 1749 patients. Doctors and patients independently completed questions on the doctor's communication skills (content and process) after a consultation. Multilevel modeling provided an estimate of the patient and doctor variance components at both the dyad-level and the doctor-level. We computed correlations between patients' and doctors' perceptions at both levels to assess how congruent they were. Consensus among patients of a specific doctor was assessed using intraclass correlation coefficient (ICC). The mean score of the rating of doctor's skills according to patients was 4.58, and according to doctors was 4.37. The dyad-level variance for the patient was .38 and for the doctor was .06. The doctor-level variance for the patient ratings was .01 and for the doctor ratings, .18. The correlation between both the patients' and the doctors' skills' ratings scores at the dyad-level was weak. At the doctor-level, the correlation was not statistically significant. The ICC for patients' ratings was .03 and for the doctors' ratings .76. Overall, this study suggests that doctors and their patients have a very different perspective of the doctors' communication skills occurring during routine clinical encounters. (C) 2009 Elsevier Ltd. All rights reserved.