照护的手艺:医方情感支持如何促成患方信任

The Craft of Caregiving:How Emotional Support from Medical Workers Contributes to the Establishment of Patients’Trust

虽然调查数据显示近些年来中国民众对就医或住院过程的评价已出现好转趋势,但公众自身的实际感受并不一定与此同步。这与现代医学强调医疗体制和技能提升以改善医患关系的医患信任塑造模式有关,这一模式未能充分满足患方就医时的多种情感诉求,也未能充分彰显医方的情感照护技艺对患方情感信任的促成作用。基于A市某医院儿童血液病中心的参与观察研究发现,医方常在医院的制度化安排之外为患儿家长提供情感支持,以助其减少消沉情绪、缓解治疗恐惧和歧视感知、宣泄负面情绪,或是帮助无法治愈的患儿家庭以更少的痛苦走过生命的最终阶段。这些情感支持可直接提升患方对医方的情感信任,进而促进其对医务人员及其所在医院的认知信任和制度信任,也使医务人员自身获得情感的慰藉和职业的成长,从而形成一种良性的循环。但是,医方情感支持的实现具有高度的人格化特征,是一种需要长期习得且难以标准化施展和迁移的“手艺”。在现有医疗体系下培养一种不完全基于治疗效果、充分尊重治疗过程中情感付出的治疗文化,还需要持久不断的反思与努力。

While survey data indicates a positive trend in the overall social attitude towards medical treatment and hospitalization process in recent years,the actual sentiments of the Chinese public may not necessarily align with these findings.This discrepancy is intricately linked to the doctor-patient trust-building model prevalent in modern medicine,which prioritizes enhancements in medical systems and skills as a means to foster improved doctor-patient relationships.However,this model falls short in adequately addressing the diverse emotional needs of patients during their medical encounters and does not effectively showcase the emotional care provided by doctors.Consequently,the role of skill acquisition in nurturing emotional trust among patients remains incomplete.Based on a participant observation study conducted by the Children’s Blood Disease Center in China,it was found that the doctor often provides emotional support to the parents of children apart from the hospital’s institutional arrangements to help them reduce depression,alleviate treatment fear and perception of possible discrimination,relieve negative emotions,or help families walking through the final stages of life with less suffering.These endeavors can directly enhance the patients’emotional trust in the doctor,and then promote the cognitive trust and institutional trust toward medical professionals and hospitals.In addition,these feedbacks can also enable the medical staff themselves to experience a sense of emotional comfort and professional growth.Thus,a positive loop of doctor-patient relationship could be sustained.However,the realization of medical emotional support as a craft rather than a standard technique is highly personalized.Under the existant medical system,cultivating a treatment culture that is not entirely based on the treatment effect and fully respects the emotional effort in the treatment process still requires continuous reflection and hard work.