互联网医患功能沟通质量测量工具开发与评价

“互联网+医疗健康”发展迅速，但医患沟通质量不高，且缺乏针对性测量工具。以高血压为例，遵循Hinkin量表开发步骤，开发了互联网医患功能沟通质量测量工具，包括患者信息收集质量、诊断信息提供质量、治疗决策制定质量、疾病及治疗相关行为促进质量4个维度共计25个条目。实证评价验证了其科学性，可以对互联网医患功能沟通质量进行测量，有助于提高我国互联网医患功能沟通质量水平。     

互联网医患功能沟通质量内涵模型构建

在前期研究开发互联网医患功能沟通质量测量工具的基础上，通过实证研究，采用偏最小二乘结构方程模型方法,构建了互联网医患功能沟通质量内涵模型，并评价了模型的推广价值。这为改善医患双方功能沟通行为、提高沟通质量提供了参考依据。     

“质量、服务、沟通、文化”全方位构建和谐医患关系

大型公立医院医患关系的和谐程度不仅关系到患者对医院的直观评价,更关系到医改的成败和医疗卫生事业的长远发展。大型公立医院在医疗质量、服务水平、主动沟通、多方联动以及医院文化等方面的创新举措与大胆尝试,可以为整个社会的医患和谐发挥引导和示范作用。     

从规培医生对患者就医体验评价看医患沟通改良

目的了解目前镇江市3家具有规培资格综合性医院内规培医生对患者就医体验的评价,为提升年轻医师职业道德,构建和谐医患关系提出措施和建议。方法从就医认知、就医行为、就医态度三个方面对规培医生进行问卷调查。结果规培医生对患者就医的体验评价总体不算高,科学认知、配合支持、理解信任的平均数分别为3.297、3.468和4.109。不同文化程度、不同收入、不同科室的规培医生体验评价差异较大。结论医患双方有共同的防治疾病的目的,要实现这一目的有赖于有效的医患沟通。作为医患关系的主导者,更需要医务人员对职业有准确定位,调整好工作心态,从维护患者权益出发给予及时有效的专业帮助。     

医患沟通满意度影响因素分析

目的:分析和研究医患沟通满意度的影响因素,为临床护理提供实验依据.方法:医院自己设计调查问卷,问卷的主要内容为影响医患沟通满意度的影响因素.对本院部分门诊医生和患者进行问卷调查.结果:调查结果显示,医生的沟通技巧、信息沟通、时间以及医患之间的信任情况等是影响医患沟通满意度的重要因素.结论:医生的沟通技巧、信息沟通、时间以及医患之间的信任情况等对医患沟通满意度的影响较大,因此要求医生能够从这些方面着手,提高医患沟通的满意程度.     

妇产科医生医患沟通能力培养

目的：研究对妇产科医生进行医患沟通能力培养的有效方法及效果。方法：选取我院20名妇产科医生作为研究对象,随机分为采用常规方式对患者进行诊疗的对照组（10名）与采用强化医患沟通能力培养的观察组（10名）,每组均配备有住院医师,主治医师及副主任医师。各蛆经为期2个月的试验研究后,通过调查问卷分析各组医生、患者与其家属对于此次试验的结果反馈。结果：通过调查问卷的反馈结果表明,采用强化医患沟通能力培养的的观察组包括自我评价、患者评价等方法均显著优于对照组（p〈0.05）,该培养方式更受临床医生欢迎,可显著调动医生的学习积极性,达到不断提升医患沟通能力的目的,并取得了患者与其家属的广泛认可。结论：在诊疗过程中,加强与患者交流,通过保证患者知情权,诚恳待人,保持良好态度,认真倾听患者疾苦,并学会容忍、宽容等方式有效提高医患沟通能力,优化医患关系,值得推广。     

PBL在临床医生医患沟通技巧培训中的应用

目的探讨以问题为基础的教学法在临床医生沟通技巧培训中的应用。方法对某医院150名临床医生采用PBL教学方法,充分调动医生们的学习积极性,结合头脑风暴法引导医生们提炼出医患沟通中的关键要素和临床沟通技巧,并请某患者（已愈）现场参与,模拟演练。结果经过沟通技巧培训,医生们医患沟通意识、医患沟通能力和沟通技巧得到明显提升。结论 PBL教学培训法用于临床医生医患沟通技巧培训效果较好,有条件的医院可以将其推广应用。     

肿瘤医患沟通现状调查及患者满意度分析

目的探讨肿瘤治疗中医患沟通现况,及患者的满意度、随访的依从性。方法对武汉3家医院的279例患者进行问卷调查,收集沟通时间、满意度等信息,出院后对患者进行电话随访。结果 44.1%的患者自述每天与医生沟通时间5min;女性或主动沟通的患者有更长的沟通时间;78.5%患者表示对医患沟通满意,男性、大学及以上学历或沟通充分的患者满意度更高;高满意度的患者随访依性较不满意者高。结论肿瘤治疗中,医患沟通时长不足,部分患者对医患沟通表示不满意;医患沟通满意度提升有助于增加随访率。     

实施"零缺陷"医患沟通 提升医院服务质量

医患沟通是医院提升服务功能的重要办法,本文重点讨论了医院提升服务功能的重要性,针对问题提出了"零缺陷"医患沟通的做法和效果,并认为"零缺陷"医患沟通是医院提升服务质量,解决医患矛盾的良好方法.     

浅谈医患沟通在现代医院建设中的重要性

目的探讨医患沟通在现代医院建设中的重要性。方法通过统计我院发生过的医疗纠纷46例,分析医患沟通发生的原因和解决方式,为改善医患关系提供新的思路。结果良好的医患沟通有助于医务工作者和患者之间相互理解,对于提高患者治疗的依从性,保证医疗质量具有重要作用。结论良好的医患沟通在现代医院建设中具有重要作用,临床医生及医院管理人员应充分重视医患沟通,不断促进良好的医患沟通,提高医患沟通的技巧。     

医患沟通现况调查及改进对策

以某大型公立医院为例,对非技术性医患沟通的现况及影响因素做了调查。造成医患沟通效果不佳的主要因素有医患信任缺乏、忽视患者沟通需求、医生沟通技巧欠缺以及医患双方人文素养不高等。提出了努力构建"以病人为中心"的医患沟通文化、加强医务人员的伦理和职业素质教育,夯实医患沟通的道德感情基础,提高患方素质等改进建议。     

Factors Influencing Communication with Doctors via the Internet: A Cross-Sectional Analysis of 2014 HINTS Survey

Based on Street’s (2003) ecological framework of communication in medical encounters, this study examined personal, interpersonal, and media factors that could influence patients’ use of the Internet to communicate with doctors. Results from data analysis of responses from the 2014 Health Information National Trends Survey showed that patient activation and ease of Internet access were two positive predictors of online doctor-patient communication. In addition, patients’ trust in doctors positively moderated the relationships between patient activation and online doctor-patient communication, and between perceived health status and online doctor-patient communication. Finally, the quality of patients’ past experiences communicating with doctors had a positive moderation effect on the association between health information seeking behavior and online doctor-patient communication. Implications and limitations are discussed.     

Limiting factors on the transformative powers of e-mail in patient-physician relationships: a critical analysis

In this article I analyze doctor-patient use of e-mail within the context of the evolving doctor-patient relationship and ongoing changes in the U.S. health care system. Evidence from the published literature on doctor-patient relationships and doctor-patient communication, empirical studies of uses of the Internet by doctors and patients, and commentaries about the Internet's role in health care are examined and discussed to reveal common, unsupported assumptions about the likely impact of e-mail on the doctor-patient relationship and also the value structure associated with current e-mail practices between doctors and patients. I argue that existing research does not adequately account for the technical, professional, and economic forces that are shaping doctor-patient use of e-mail. I conclude that physicians' preferences for technical, instrumental exchanges with patients will likely mitigate the positive influence that e-mail could have on the doctor-patient relationship, and doctor-patient communication is unlikely to improve as a result of their use of e-mail.     

医院肿瘤科在医患沟通工作的实践与体会

构建和谐医患关系,良好的医患沟通是不可或缺的环节。在诊疗过程中应把医患沟通作为临床工作的重要组成部分对待,精细化管理制定医患沟通具体流程,加强对医师业务能力及沟通能力的培养,强化医德医风教育及法律意识,提高医患沟通的有效率及医疗质量、医疗安全的水平。该文就该院肿瘤科在提高医患沟通的有效率所采取的措施和方法及过程中的体会做一报道。     

护患沟通在构建和谐护患关系中的临床作用

目的:探讨临床护患沟通合理性对于改善护患关系的临床作用。方法:本研究选择我科采取输液治疗的患者进行调查研究,调查其对临床输液中的护患沟通满意情况。对研究人群分为两组进行输液治疗前培训,调查实施护患沟通前、后输液治疗服务情况的满意率。结果:对护患沟通管理实施后进行评估,临床输液患者满意率、临床疗效等均取得良好的效果。实施前输液治疗患者满意率为60.45%,实施后满意率为94.02%,实施前后患者对输液治疗服务满意情况对比差异有统计学意义(x2=35.73,P<0.05)。结论:重视临床护患关系沟通可有效地提高护患之间的信任,加强护患沟通的合理性为临床护理服务。     

Communication in general practice: differences between European countries

BACKGROUND: Based on differences in national health care system characteristics such as the gatekeeping role of GPs (at the macrolevel) and on diverging GP and patient characteristics (at the microlevel), communication may differ between countries. Knowledge of the influence of these characteristics on doctor-patient communication will be important for setting European health care policies. OBJECTIVES: Our objectives were (i) to compare doctor-patient communication in general practice between European countries; and (ii) to investigate the influence of the gatekeeping system and GP and patient characteristics on doctor-patient communication in general practice. METHODS: Fifteen patients per GP (in total 2825 patients) of 190 GPs in six European countries were included. Participating countries were The Netherlands, Spain, the UK (gatekeeping countries), Belgium, Germany and Switzerland (non-gatekeeping countries). Data were collected by means of patient and GP questionnaires and observation of videotaped consultations, and analysed by one-way and multilevel, multivariate analysis. RESULTS: Differences in communication between countries were found in: affective and instrumental behaviour; biomedical and psychosocial talk; GPs' patient-directed gaze; and consultation length. The study showed that GPs' gatekeeping role (with registered patients) was less important for doctor-patient communication than was expected. Patient characteristics such as gender, age, having psychosocial problems, and familiarity between the doctor and the patient were the most important in explaining differences in communication. CONCLUSION: The gatekeeping role of GPs is hardly important in explaining doctor-patient communication. The relationship is more complex than expected. Patient and GP characteristics are more important. Cultural factors should be included in future studies.     

加强医患沟通 努力构建和谐医患关系

医患沟通是整个医疗过程的一个重要环节，实施医患沟通是病人和家属的迫切需求，也是提高医疗服务质量和当前医院生存发展的需要，加强医患沟通可以增强医务人员与患者之间的相互理解，增加患者对医务人员及医院的信任，增强患者战胜疾病的信心，良好的医患沟通是构建和谐医患关系，减少医患纠纷的有效方法之一。     

浅议和谐医患关系的构建

医患关系是社会关系中的重要关系,在当今社会,医患矛盾却成了医患关系的代名词。作者对医患关系现状进行分析并提出构建和谐医患关系主要应以加强医患间的诚信建设为契机,从加强医院管理、提高医疗质量入手,转变管理和服务理念;医院要加强医患纠纷的前期处理,将纠纷化解在萌芽状态;同时建议各方形成合力化解医患纠纷,并应建立医患纠纷处理的长效机制。