中医理论体系背景下构建中医医患沟通十阶段模式的探讨

Construction of a ten-stage mode for patient-physician communication in the context of theoretical system of traditional Chinese medicine

构建良好的医患沟通模式对于减少医患纠纷具有重要的现实意义。目前,国内外已提出了多种医患沟通模式,但缺乏对中医医患沟通模式的研究。本研究在综合分析国内外医患沟通模式研究进展的基础上,系统归纳中医理论体系中所蕴含的医患沟通思想,根据中医临床实践特点,提出了适用于中医医患沟通的十阶段(Ten Stage,TS)模式。TS模式包括以下10个阶段:建立联系、倾听述说、补充提问、四诊合参、现代检查、明确诊断、提供方案、共同决策、随访评价和优化方案。TS模式填补了当前中医医患沟通模式研究的空白,为中医医患沟通提供了系统化框架,强调了医患共同决策和有效沟通的重要性,有望成为促进医患良好关系,进而提高中医临床治疗疗效的新医患沟通模式。

A good doctor-patient communication(DPC)mode is of great practical significance in reducing medical disputes.While numerous DPC modes have been proposed at home and abroad,few researches have been conducted from the perspective of traditional Chinese medicine(TCM).This article elucidates the ideas of DPC in the theoretical system of TCM,analyzes the research advances in DPC modes,and proposes a TCM-based ten-stage(TS)DPC mode.The TS model consists of the following ten stages:establishing contact,listening,supplementing questions,combining the four TCM diagnostic methods,modern examinations,clarifying diagnosis,providing a treatment plan,joint decision-making,follow-up evaluation,and optimization of the plan.The TS model addresses the gap in current research on DPC in TCM by providing a systematic framework that emphasizes the importance of doctor-patient joint decision-making and effective communication.It is expected to become a new DPC model that promotes a good relationship between doctors and patients,thus improving the efficacy of clinical treatment in TCM.