基于PubMed数据库的医患关系研究现状及热点分析

Physician-patient relations： current studies and hotspot analysis using PubMed database

目的 检索医患关系研究的相关文献，分析当前研究现状和热点。方法 分别以＂physician-patient relations＂＂nurse-patient relations＂为主题词，采用主题检索方法对PubMed数据库中2013年至2017年发表的医患关系相关文献，进行分析并对比，下载医患关系相关文献题录，分析文献的发表年份、来源期刊及期刊所属国家、第一作者。采用一种基于齐普夫定律的识别语料中高低词频分界点的新方法确定高频词，使用BICOMB统计主要主题词出现的频次，形成词篇矩阵，再使用SPSS 24.0软件进行聚类分析生成树状图。结果 共检索4 924篇医患关系相关文献，截取频次≥31次的主题词74个，共检索2 145篇护患关系相关文献，截取频次≥25次的主题词41个。共词聚类结果分析显示，近5年国外医患关系形成了6个热点：知情同意等伦理问题、沟通壁垒、信任、改善医患关系的培训课程实施与构建、临终关怀、患者参与决策。护患关系形成了4个热点：健康知识态度行为、沟通和心理护理、精神科及临终护理、以患者为中心及患者教育。结论 对近5年国外医患、护患关系的研究热点进行共词聚类分析，有助于了解该时段医患关系的研究现状和发展趋势。

Objective To retrieve literature on physician-patients relations for analysis of current studies and hotspots.Methods Papers on physician-patient relations published from January 2013 to September 2017 were retrieved in PubMed using such key words as＂physician-patient relations＂and＂nurse-patient relations＂respectively for analysis and comparison. Bibliographies of literature on such relations were downloaded, and their publication years, journals, and countries of the journal, as well as their first authors were also analyzed. High frequency words were chosen using a new method based on Zipf′s law to identify the cut-off points of high-low frequency words in the corpus. Then the co-word matrix was formed using BICOMB2 to calculate the frequency of main key words, and a dendrogram was developed using SPSS 24.0 for clustering analysis.Results A total of 4 924 papers on physician-doctor relations were reviewed using 74 key words with occurrence higher than 31 times, and 2 145 papers on nurse-patient relations were retrieved using 41 key words with occurrence higher than 25 times. Co-word clustering analysis found six research focuses in recent five years：＂informed consent and ethical issues＂,＂communication barriers＂,＂trust＂,＂implementation and construction of training courses for improving the relationship between doctors and patients＂,＂hospice care＂, and＂patient participation in shared decision-making＂. It also found four research focuses on nurse-patient relations：＂health knowledge, attitude and behavior＂,＂communication and psychological nursing＂,＂psychiatry and hospice care＂, and＂patient centered and patient education＂.Conclusions Co-word clustering analysis found six research focuses in the recent five years helps understand the current situation and development trend.