Communication interventions make a difference in conversations between physicians and patients - A systematic review of the evidence
Communication interventions make a difference in conversations between physicians and patients - A systematic review of the evidence
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DOI：
10.1097/01.mlr.0000254516.04961.d5
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发表时间：
2007-04-01
期刊：
影响因子：
3
通讯作者：
Frankel, Richard M.
中科院分区：
文献类型：
--
作者：
Rao, Jaya K.;Anderson, Lynda A.;Frankel, Richard M.
目的：我们试图综合研究干预措施的结果，以增强门诊就诊时医生和患者的沟通行为。方法：我们检索了1966年至2005年间的6个数据库，以确定用于系统回顾和文献综合的研究。符合条件的研究测试了沟通干预；为随机对照试验（RCTs）；以客观评价语言交际行为为主要结果，并以英文出版。干预措施以类型（如信息、建模、反馈、实践）、实施策略和总体强度为特征。我们提取了干预对沟通结果（如人际和信息交换行为）影响的信息。我们检验了干预措施在改善医患沟通行为方面的有效性。结果：我们回顾了36项研究：18项涉及医生；15例;两者都是。在医生干预中，76%包括3或4种类型，通常以实践和反馈会议的形式。在患者干预中，33%涉及I型，几乎全部在候诊室进行。干预医生比对照组更有可能在整体沟通方式上获得更高的评分，并表现出以患者为中心的特定沟通行为。干预患者从医生那里获得了更多的信息，并且在访问期间表现出比对照组更多的参与。结论：干预与改善医患沟通行为有关。未来研究面临的挑战是设计有效的患者和医生干预措施，并将其整合到实践中。
Objective: We sought to synthesize the findings of studies examining interventions to enhance the communication behaviors of physicians and patients during outpatient encounters.Methods: We conducted searches of 6 databases between 1966 and 2005 to identify studies for a systematic review and synthesis of the literature. Eligible studies tested a communication intervention; were randomized controlled trials (RCTs); objectively assessed verbal communication behaviors as the primary outcome-, and were published in English. Interventions were characterized by type (eg, information, modeling, feedback, practice), delivery strategy, and overall intensity. We abstracted information on the effects of the interventions on communication outcomes (eg, interpersonal and information exchanging behaviors). We examined the effectiveness of the interventions in improving the communication behaviors of physicians and patients.Results: Thirty-six studies were reviewed: 18 involved physicians; 15 patients; and 3 both. Of the physician interventions, 76% included 3 or 4 types, often in the form of practice and feedback sessions. Among the patient interventions, 33% involved I type, and nearly all were delivered in the waiting room. Intervention physicians were more likely than controls to receive higher ratings of their overall communication style and to exhibit specific patient-centered communication behaviors. Intervention patients obtained more information from physicians and exhibited greater involvement during the visit than controls.Conclusions: The interventions were associated with improved physician and patient communication behaviors. The challenge for future research is to design effective patient and physician interventions that can be integrated into practice.