Effects of a physician communication intervention on patient care outcomes
Effects of a physician communication intervention on patient care outcomes
复制标题
DOI：
10.1007/bf02600266
复制
发表时间：
1996-03-01
影响因子：
5.7
通讯作者：
Baker, LH
中科院分区：
文献类型：
--
作者：
Joos, SK;Hickam, DH;Baker, LH
目的：确定旨在改善医患沟通的干预措施是否会增加医生引起患者关注的频率，改变其他沟通行为，并改善卫生保健结果。设计：前测-后测设计，将医生随机分配到干预组或对照组。设置：一所大学附属退伍军人事务医院的全科诊所。患者/参与者：42名医生和348名连续性护理患者服用慢性病处方药。干预：干预组医生接受4.5小时的培训，了解如何激发和回应患者的担忧和请求，患者在随后的临床访问之前填写患者服务请求问卷。测量和主要结果：与对照组相比，干预组医生引起患者所有担忧的频率增加(p=.032)，患者对从医生那里获得的信息量的感知确实显著增加(p<；.05)，但实际变化幅度很小。患者对医生的满意度在基线时很高，干预后也没有明显变化，同样，干预与患者服药或预约依从性的变化无关，也不会对门诊利用产生任何影响。结论：低强度干预改变了医生的行为，但对患者的结果如满意度、依从性或利用率没有影响，干预可能需要专注于医生和患者才能产生最大的效果。
OBJECTIVE: To determine whether an intervention designed to improve patient-physician communication increases the frequency with which physicians elicit patients' concerns, changes other communication behaviors, and improves health care outcomes.DESIGN: Pretest-posttest design with random assignment of physicians to intervention or control groups.SETTING: General medicine clinics of a university-affiliated Veterans Affairs Hospital.PATIENTS/PARTICIPANTS: Forty-two physicians and 348 continuity care patients taking prescription medications for chronic medical conditions.INTERVENTIONS: Intervention group physicians received 4.5 hours of training on eliciting and responding to patients' concerns and requests, and their patients filled out the Patient Requests for Services Questionnaire prior to a subsequent clinic visit, Control group physicians received 4.5 hours of training in medical decision-making.MEASUREMENTS AND MAIN RESULTS: The frequency with which physicians elicited all of a patient's concerns increased in the intervention group as compared with the control group (p = .032), Patients perceptions of the amount of information received from the physician did increase significantly (p < .05), but the actual magnitude of change was small. A measure of patient satisfaction with the physicians was high at baseline and also showed no significant change after the intervention, Likewise, the intervention was not associated with changes in patient compliance with medications or appointments, nor were there any effects on outpatient utilization.CONCLUSIONS: A low-intensity intervention changed physician behavior but had no effect on patient outcomes such as satisfaction, compliance, or utilization, Interventions may need to focus on physicians and patients to have the greatest effect.