SEGUE量表评估住院医师医患沟通能力分析

Analysis of the effects on residents' medical communication skills with SEGUE framework

目的应用医患沟通技能评价量表(SEGUE量表)调查住院医师临床沟通能力现况,分析目前医患沟通存在的主要问题并探讨解决办法。方法 2015年1至6月以及2015年4至10月先后两次对182名和189名在我院参加规范化培训的住院医师进行SEGUE量表评估,通过对比两次调查结果分析住院医师临床沟通能力变化。结果 SEGUE量表评估3个月后更多的住院医师能够关注影响疾病的社会、心理或情感因素(37.16%vs.10.98%,P<0.001),并且能够与患者讨论健康的生活方式或疾病预防措施(42.62%vs.10.40%,P<0.001)。更多的住院医师能够在交流过程中给患者说话的时间和机会(42.08%vs.30.64%,P=0.025),并告诉患者其目前的身体状况(39.34%vs.8.67%,P<0.001)以及向患者表达关心使患者感到温暖(53.01%vs.26.59%,P<0.001)。结论 SEGUE量表评估对住院医师医患沟通能力有一定的提升作用,加强医患沟通培训是提升住院医师医患沟通能力的主要解决办法。

Objective To assess the residents' communication skills with SEGUE framework, to analyze the problems existed in the communication between doctors and patients, and to explore the solutions. Methods We assessed 182 and 189 residents with SEGUE framework sequentially in 3 months(from January 2015 to June 2015, April 2015 to October 2015), and analyzed the changes between the two assessments. Results After 3 months of the first SEGUE framework assessment, more residents could explore psychosocial or emotional factors of diseases(37.16% vs. 10.98%, P<0.001) and discuss lifestyle issues or prevention strategies(42.62% vs. 10.40%, P<0.001). And more residents could give patients opportunity or time to talk(42.08% vs. 30. 64%, P=0.025) and teach them about their situations(39.34% vs. 8.67%, P<0.001). In addition, more residents learnt to express caring and concern or use empathy in the communications(53.01% vs. 26.59%, P<0.001). Conclusion The assessment of SEGUE framework could improve the communication skills of residents appropriately. But it is more important to enhance the training of doctor-patient communication skills.