医患的圆融——基于骨科保守治疗个案的叙事研究

Good Doctor-Patient-Communication:narrative research on a case study of an orthopedic patient with conservative treatment

以广东省某地级市三甲医院骨科为研究场所,用参与式观察法研究真实情境下骨科门诊及病房的医患交际,通过个案叙事揭示保守治疗中医患沟通存在的问题,提出好的医患沟通应具备的要素:医方充分了解患者病情,并予以充分告知,提出首选治疗方案;患方听取并理解医方的解释,提出疑惑和想法;医患双方互换观点,患方明确医方的医疗原则,医方把握患方的需求和目的;在满足患方合理需求的基础上,双方达成共识,作出最合理的临床决策。

Based on a case study in a tertiary hospital in Guangdong,Doctor-Patient-Communication in orthopedics clinic and ward under realistic situation were examined by participatory observation.This paper,through the narrative analysis of a specific case,reveals the existing problems in Doctor-Patient-Communication on those who receive conservative treatment in orthopaedics department.Thus,the authors proposed four essential elements of Good Doctor-Patient-Communication：Firstly,doctors grasp the whole medical information of patients,making it clear to them and inform to them the prior regimens;Secondly,patients listen carefully and speak out their minds about the disease based on full understanding of it;Thirdly,both the doctors and patients exchange views about the disease and treatment options,the former the patient needs and goals or expectations,the latter the medical principles;Last,once the plausible requirements of patients were met,agreement were reached and the optimal clinical decision would then be made.