Communication Profiles of Psychiatric Residents and Attending Physicians in Medication-Management Appointments: A Quantitative Pilot Study
Communication Profiles of Psychiatric Residents and Attending Physicians in Medication-Management Appointments: A Quantitative Pilot Study
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DOI：
10.1176/appi.ap.10120030
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发表时间：
2012-03-01
影响因子：
2.5
通讯作者：
Cruz, Mario
中科院分区：
文献类型：
--
作者：
Castillo, Enrico G.;Pincus, Harold A.;Cruz, Mario
目的：定量分析精神科住院医师和主治医师的交流特征和语音语调的差异。方法：采用Roter交互作用分析系统（RIAS）对4个门诊49例住院患者和35例就诊患者的药物管理预约进行录音分析。非参数测试用于比较在决策过程中用于建立关系、激活和合作的言语比例的差异，以及数据收集/咨询/患者教育。精神科医生的声调所表达的情感差异也得到了检验。结果：住院医生的访问时间是主治医生的两倍（28.2分钟对14.1分钟），住院医生在建立关系（23%对20%）和启动/合作（36%对28%）方面的谈话中所占的比例要大得多，而主治医生在生物医学相关数据收集/咨询/患者教育方面所占的比例要大得多（31%对20%）。对语音语调的分析显示，住院医生被认为听起来更友好、更有同情心，而主治医生则被认为听起来更强势、更匆忙。结论：这些发现显示了明显的沟通特征和语音语调差异。未来的精神病学交流研究应解决预约时间、精神科医生/患者特征和其他潜在混杂因素对精神科医生患者交流的影响。
Objective: The authors quantitatively examined differences in psychiatric residents' and attending physicians' communication profiles and voice tones.Methods: Audiotaped recordings of 49 resident patient and 35 attending patient medication-management appointments at four ambulatory sites were analyzed with the Roter Interaction Analysis System (RIAS). Nonparametric tests were used to compare differences in proportions of speech devoted to relationship-building, activating, and partnering in decision-making processes, and data-gathering/counseling/patient education. Differences in affect expressed by psychiatrists' voice tones were also examined.Results: Residents' visits were twice as long as Attendings' visits (28.2 versus 14.1 minutes), and residents devoted a significantly greater proportion of their talk to relationship-building (23% versus 20%) and activating/partnering (36% versus 28%) aspects of communication, whereas Attendings devoted a greater proportion to biomedically-related data-gathering/counseling/patient education (31% versus 20%). Analysis of voice tones revealed that residents were perceived as sounding significantly friendlier and more sympathetic, versus Attendings, who were rated as sounding more dominant and rushed.Conclusion: These findings show distinct communication profiles and voice-tone differences. Future psychiatric communication research should address the influence of appointment length, psychiatrist/patient characteristics, and other potential confounders on psychiatrist patient communication.