普通外科实习医生与病人沟通技能现状分析及对策

Status of general surgeons and patients communication and measures for improvement

目的:调查实习医生医患沟通的现状和存在的问题以及针对存在的问题,提出加强医患沟通的对策。方法:随机选取2016年11月至2017年6月于普通外科实习的学生(包括本科38人、专升本学生38人)为研究对象,通过运用标准化病人教学、临床带教等形式培训实习医生与患者的沟通能力,利用国际通用的医患沟通技能评价量表(SEGUE Framework)、观察法、访谈法于实习医生到普通外科实习的第1、15、30天评估实习医生医患沟通能力结果入科第15天较入科第1天、入科第30天较入科第15天的测评得分、考官总体评价均有统计学意义(P <0. 05),得分较少的项目主要有:告诉病人他(她)目前身体情况、根据病人的理解能力进行适当调整、体察病人的暗示、进一步说明下一步的诊治方案。结论:通过发现普通外科临床实习医生在医患沟通过程中的缺陷进行有针对性的培训教学后,解决了实习医生与病人的沟通障碍,可以提高实习医生的医患沟通水平。

Objective: To investigate the current situation and existing problems of interns’ doctor-patient communication,and to solve these problems,this paper puts forward some countermeasures to strengthen doctor-patient communication. Students( including 38 undergraduate students and 38 top up degree program students) who were interns in general surgery from November 2016 to June 2017 were randomly selected as the research objects,and interns were trained by standardized patient teaching and clinical teaching. The communication ability of patients was evaluated by SEGUE framework,observation method and interview method on the first,fifteenth and thirtieth days of internship to general surgery. The results of the 15 days of internship were significantly higher than those of the first day and the 30 days of admission( P< 0. 05). The main items with less scores are: telling the patient his or her current physical condition,adjusting appropriately according to the patient’s understanding ability,observing the patient’s suggestion,further explaining the next step’s diagnosis and treatment plan conclusion,solving the problem of interns and patients by finding out the deficiencies in the process of doctor-patient communication and conducting targeted training and teaching. The communication barrier of interns can improve the level of doctor-patient communication.