应用LCSAS和SP评估院内青年医生医患沟通能力的探索

Application of LCSAS and SP to evaluate the doctor-patient communication ability of young doc-tors in our hospital

目的 了解我院青年医生医患沟通能力现状及相关影响因素.方法 在各临床科室40岁以下的医生人群中,按30%的比例随机选取32名医生;结合利物浦医生沟通能力评价量表（Liver-pool communication skills assessment scale,LCSAS）修订版和标准化病人（standardized patients,SP）,对青年医生的医患沟通能力进行测评;采用SPSS 21.0行描述统计、t检验及方差分析.结果 青年医生沟通礼仪平均得分为（2.00±0.15）,沟通技巧平均得分为（1.74±0.29）,沟通技能平均得分为（3.74±0.39）.沟通礼仪、沟通技巧及沟通技能评价的检出率（小于2分的人群）分别为33.3%、81.5%、85.2%.内、外科医生的沟通礼仪及沟通技能得分差异有统计学意义（P〈0.05）.不同年龄阶段医生的沟通礼仪得分差异有统计学意义（F=3.641,P=0.028）,20~25岁的医生沟通礼仪得分低于其他年龄阶段医生（P〈0.05）.不同职称医生的沟通礼仪得分差异有统计学意义（F=4.410,P=0.023）,见习医师的沟通礼仪得分低于医师及主治医师（P〈0.05）.结论 我院青年医生的沟通技能总体处于中间状态,沟通礼仪较好,沟通技巧一般,个体差异较大.医院应从沟通能力低分人群着手,培养医生在生物-心理-社会医学模式下的医患关系思维;帮助新进员工做好角色转换、情绪管理及职业承诺,鼓励患者参与;全方位、多层次提升医生的沟通能力.

Objective To understand the status quo of our young doctors＇ doctor-patient communi-cation and related influencing factors. Methods Among the doctors under the age of 40 in various clinical departments, according to 30% proportion, we randomly selected 32 doctors, and combined with revised Liverpool communication skills assessment scale （LCSAS） and standardized patients （SP）, the doctors＇ ability of doctor-patient communication was evaluated. Descriptive statistics, t test and variance analysis were per-formed by SPSS 21.0 lines. Results The average score of communication etiquette of young doctors was （2.00±0.15）, and the average score of their communication skills was （1.74±0.29）, and the average score of their communication technical ability was （3.74±0.39）. The detection rate of communication etiquette, communication skills and communication skills evaluation （less than 2） was 33.3%, 81.5%, and 85.2%, respectively. Physicians and surgeons＇ scores in communication etiquette and communication skills dimen-sion had significant difference （P〈0.05）. Significant difference was found in different ages doctor communi-cation protocol （F=3.641, P=0.028）, and 20 to 25 years old doctors＇ score in communication manners was significantly lower than other ages （P〈0.05）. There were significant differences in the scores of doctors of different title in communication etiquette （F=4.410, P=0.023）, and the trainee doctors＇ communication etiquette score was significantly lower than the physician and surgeon （P〈0.05）. Conclusion The commu-nication skills of young doctors in our hospital are generally in the middle state, and their communication etiquette is good, communication skills are general. There are great individual differences. Hospital should begin from those whose communication ability are low, cultivate their biology-psychology-social medicine thinking mode of the doctor-patient relationship , help new employees complete the role transformation , emotion management, and professional commitment, and encourage patients to participate in the medical process, so as to improve the doctors＇ communication ability in all directions and at different levels.