基于RIAS方法的医生沟通行为对脑卒中患者生活满意度的影响研究

An Empirical Study on The Influence of Physicians' Communication Behaviors on Health Outcome of Stroke Patients Based on RIAS Method

目的:研究医生沟通行为影响患者满意度和生活满意度的影响作用。方法:随机抽取上海市各级医院脑卒中门诊患者及医生共360人,采用Roter交互分析系统方法将医患门诊会话录像,采集医生沟通行为"话语",并转换可测变量用于研究。结果:患者满意度在T1时间内受到融洽关系建立(β=0. 20,P <0. 01)、积极的情感语调(β=0. 27,P <0. 01)和以患者为中心(β=0. 25,P <0. 01)显著性影响;在T2时间内受到生物信息给予(β=0. 23,P <0. 01)、积极的情感语调(β=0. 24,P <0. 01)和以患者为中心(β=0. 26,P <0. 05)显著性影响。而患者生活满意度在T1时间内则受到积极的情感语调(β=0. 31,P <0. 05)和以患者为中心(β=0. 23,P <0. 01)显著性影响;在T2时间内受到融洽关系建立(β=0. 21,P <0. 01)、积极的情感语调(β=0. 25,P <0. 05)和以患者为中心(β=0. 20,P <0. 01)显著性影响。结论:研究表明医生沟通行为对患者满意度和生活满意度均产生显著性影响,此结论为卫生管理决策者加强医生沟通行为培训,改进医患关系,提高医疗服务质量提供可操作性参考。

Objective To study the influence of physicians’communication behaviors on health outcome and life satisfaction of stroke patients.Method 360 cases of physicians and stroke outpatients were randomly sampled from hospitals in Shanghai,and studied with Roter Interaction Analysis System.Results Patients’satisfaction was significantly influenced by rapport building(β=0.20,P<0.01),positive physicians’affect(β=0.27,P<0.01)and patient-centeredness(β=0.25,P<0.01)at T1,and influenced by biomedical information-giving behaviors(β=0.23,P<0.01),positive physicians’affect(β=0.24,P<0.01)and patient-centeredness(β=0.26,P<0.05)at T2.While the patients’life satisfaction was significantly influenced by positive physicians’affect(β=0.31,P<0.05)and patient-centeredness(β=0.23,P<0.01)at T1,and influenced by rapport building(β=0.21,P<0.01),positive physicians’affect(β=0.25,P<0.05)and patient-centeredness(β=0.20,P<0.01)at T2.Conclusion It can be concluded that physician’s communication behaviors has significant influence on stroke patients’health outcome and life satisfaction,which will be helpful to improve the quality of medical services.