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Research On the effects of doctor-patient communication upon medical disputes

医患沟通对医疗纠纷的影响研究

基本信息

批准号：
12672191
负责人：
HAGIHARA Akihito
金额：
$ 1.92万
依托单位：
KYUSHU UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

项目摘要

The study procedure was twofold. Firstly, during the first half of the study period, with respect to the causes of medical disputes, we conducted a literature review in medicine and its' allieds fields. And we were successful in identifying the conditions of patient-physician communication that are closely related to medical disputes. These conditions were 17 types of attitudes taken by physicians during physician-patient encounter.Secondly, during the second half of the study period, based upon the findings of the above literature review, questionnaire items asking the mode of communication and precursors of subsequent medical dispute were developed. Reliability and validity of these questionaire items were tested by several pilot studies. Then we conducted a survey research in Fukuoka prefecture whose respondents were physicians and their outpatients in 2001.We got the following findings.(1) As for the level of explanation by physician on medical treatment when physicians felt that the explanation was not enough, their patients also felt the same way in several medical treatments.(2) As for the explanation by physician on the effects or side effects of medical treatment, when physicians felt that the explanation was not enough, their patients did not understand the explanation well.(3) Of the 17 communication conditions of patient-physician interaction, which have been previously shown as precursors of subsequent medical disputes, explanation of medical treatment by physician, understanding by patient, or reflection of patients' will on medical treatment were significantly related to the 15 communication conditions. Although these findings are valuable in preventing medical disputes through physician-patient communication, more studies are necessary.

研究程序有两个部分。首先，在研究的前半部分，针对医疗纠纷产生的原因，我们对医学及其相关领域的文献进行了综述。我们成功地确定了与医疗纠纷密切相关的医患沟通状况。第二，在研究的后半期，基于上述文献的研究结果，编制了关于医患沟通方式和后续医疗纠纷前兆的问卷。这些问卷项目的信度和效度进行了测试的几个试点研究。然后，我们于2001年在福冈县以医生及其门诊病人为调查对象进行了调查研究。(1)至于医师对医疗行为的解释程度，当医师认为解释不充分时，病患在数项医疗行为中也有相同的感受。(2)至于医生对药物治疗的效果或副作用的解释，当医生认为解释不够时，他们的病人并不很好地理解解释。(3)在17种医患沟通条件中，医生对医疗行为的解释、患者对医疗行为的理解、患者对医疗行为的意愿反映与15种沟通条件显著相关。虽然这些发现对通过医患沟通预防医疗纠纷有一定的参考价值，但还需要更多的研究。