The impact of patient-centered communication on patients' decision making and evaluations of physicians: a randomized study using video vignettes.
The impact of patient-centered communication on patients' decision making and evaluations of physicians: a randomized study using video vignettes.
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DOI：
10.1016/j.pec.2011.04.023
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发表时间：
2011-09
影响因子：
3.5
通讯作者：
Beach MC
中科院分区：
文献类型：
--
作者：
Saha S;Beach MC
评估以患者为中心的沟通（PCC）行为对患者对医生的评价和接受临床建议的影响。我们随机选择248名患者观看录像，标准化的小片段，描述心脏病专家在向心绞痛和三支冠状动脉疾病患者推荐搭桥手术时使用高与低程度的PCC。我们比较了患者对医生的评分和他们对医生建议的决策，对高和低PCC的小片段进行了比较。观看高PCC视频的患者总体上对视频医生的评价更好（3.01 vs. 2.12, p < 0.001），比观看低PCC视频的患者更有能力（3.22 vs. 2.66, p < 0.001）和值得信赖（2.93 vs. 2.28, p < 0.001）（所有量表的范围为0-4）。观看高PCC版本的患者更频繁地表示，如果他们是视频中的患者，他们将接受搭桥手术（96%对74%，p < 0.001）。患者对采用更多PCC行为的医生更有信心，更愿意接受基于证据的建议。PCC可以使医生更有效地提供循证护理。
To assess the impact of patient-centered communication (PCC) behaviors on patients' evaluations of physicians and acceptance of clinical recommendations. We randomized 248 patients to view video-recorded, standardized vignettes, depicting a cardiologist using a high vs. low degree of PCC while recommending bypass surgery to a patient with angina and 3-vessel coronary artery disease. We compared patients' ratings of the physician and their decision making in response to the physician's recommendation, for high vs. low PCC vignettes. Patients viewing high PCC vignettes rated the video physician more favorably overall (3.01 vs. 2.12, p < 0.001) and as more competent (3.22 vs. 2.66, p < 0.001) and trustworthy (2.93 vs. 2.28, p < 0.001) than those viewing the low PCC version (0–4 range for all scales). Patients viewing the high PCC version more frequently said they would undergo bypass surgery (96% vs. 74%, p < 0.001) if they were the patient in the video. Patients expressed greater confidence in physicians who used more PCC behaviors, and greater willingness to accept an evidence-based recommendation. PCC may make physicians more effective in the delivery of evidence-based care.
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