广东省某三甲医院三年级住院医师医患沟通能力的评价及其影响因素分析  

Evaluation of doctor-patient communication skills of senior residents in a gradeⅢclass A hospital and analysis its influencing factors

作　　者：李卉 陈柏权 李婕 程瑜 钟赟 王怀明[1] 郅敏[1] Li Hui;Chen Baiquan;Li Jie;Cheng Yu;Zhong Yun;Wang Huaiming;Zhi Min(Department of Education,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,Guangdong,China;Department of Medical Humanities,School of Medicine,Sun Yat-sen University,Guangzhou 510655,Guangdong,China)

机构地区：[1]中山大学附属第六医院教务处,广东广州510655 [2]中山大学医学院医学人文教研室,广东广州423000

出　　处：《中国毕业后医学教育》2024年第5期380-384,共5页Chinese Journal of Graduate Medical Education

摘　　要：目的评估广州某三甲医院三年级住院医师医患沟通能力并分析其影响因素。方法2023年5月对115名三年级住院医师进行问卷调查,分专业组设标准化病人,运用住院医师规范化培训(简称住培)结业临床实践能力考核标准方案(2023版)考题样题及其医患沟通评分表进行评分。结果医患沟通能力总分M(Q_(1),Q_(3))为89.00(82.00,94.00),任务完成得分37.00(35.00,38.00),综合表现得分52.00(48.00,55.00)。参与过多少种类型的知情同意谈话、月均收入是影响医患沟通能力得分的主要因素。参与过3种类型的知情同意谈话相比<3种者总分更高(95%CI:1.919±10.536,P=0.005),且任务完成得分更高[95%CI:(1.473±4.713)分,P<0.001];月均收入<10000元较≥10000元总分更高[95%CI:(-9.381±-0.629),P=0.025],且综合表现得分更高[95%CI:(-7.206±-0.021)分,P=0.049]。结论该三甲医院三年级住院医师医院沟通能力整体较好,其中参与过≥3种类型的知情同意谈话者较<3种者能更好地完成医患沟通,而月均收入<10000元较≥10000元者医患沟通的人文关怀体现得更好。Objective To investigate the doctor-patient communication ability of the third-year residents during their standardized training in a gradeⅢclass A hospital in Guangzhou and analyze its influencing factors.Methods A questionnaire survey was conducted among 115 third-year residents in May 2023.The communication skills of residents were scored by the doctor-patient communication score scale,which was from the standard plan for clinical practice ability assessment(2023 version)and different standard patients(SP)were used in different majors.Results The median(the upper and lower quartiles)of the total score of doctor-patient communication ability of residents was 89.00(82.00,94.00),the score of task completion was 37.00(35.00,38.00),and the score of comprehensive performance was 52.00(48.00,55.00).The experiences of the types of informed consent conversations and average monthly income were the main factors affecting the score of doctor-patient communication skills.The residents with the experiences of more than 3 types of informed consent conversations had higher total score than those with fewer than 3 types[95%CI:(1.919±10.536),P=0.005],and also had higher score of task completion[95%CI:(1.473±4.713),P<0.001].The residents with average monthly income of less than 10000 had higher total score than those with more than10000[95%CI:(-9.381±-0.629),P=0.025],and also higher score of comprehensive performance[95%CI:(-7.206±-0.021),P=0.049].Conclusion The communication skills of the third-year residents in the grade III class A hospital is generally good.The residents with the experiences of more than 3 types of informed consent conversations might accomplish doctor-patient communication better than those with fewer than 3 types.The residents with average monthly income of less than10000 might have better humanistic care in doctor-patient communication than those with more than10000.

关 键 词：医患沟通 住院医师规范化培训 培训强度 人文关怀 

分 类 号：C975[经济管理—劳动经济] R4[医药卫生—临床医学]