临床医生查房礼仪规范的质性研究  

Interview study on clinical doctors′ ward rounds etiquette norms

作　　者：王朝盈 白玛央宗 李斯斯 咸云 陈钟婉 徐雯奕 韩涛 郭坤灵 马浩民 张智若[1] Wang Chaoying;Bai Mayangzong;Li Sisi;Xian Yun;Chen Zhongwan;Xu Wenyi;Han Tao;Guo Kunling;Ma Haomin;Zhang Zhiruo(School of Public Health,Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海交通大学公共卫生学院,上海200025

出　　处：《中华医院管理杂志》2024年第11期851-854,共4页Chinese Journal of Hospital Administration

基　　金：2022年东方英才计划领军项目(2022-156)。

摘　　要：目的从实际查房工作中医生的言语及行为是否注重患者的感受且体现人文关怀出发,归纳临床医生查房礼仪规范要素,以期为提升患者的治疗效果和就医体验管理提供参考。方法2023年7—10月,采用目的抽样方法在全国范围内选取东、中、西和东北地区有查房经验的16名临床医生,以线上视频的方式围绕查房时的礼仪规范问题进行半结构访谈,采用Colaizzi七步分析法对访谈资料进行归纳分析。结果共提炼获得友善、关怀的肢体语言;准确、易懂、清晰、及时的解释;适当的表扬和肯定,鼓励患者主动参与病情管理;对患者及家属就疾病相关注意事项给予叮嘱4个主题;并将4个主题总结为"查房四要",即"一问病把身俯,二解,三扬,四叮嘱"。结论可将"查房四要"作为临床查房医生工作流程中必须做到的内容在医疗质量管理过程中加以明确,并建议在全国进行推广,以进一步提升临床医生的沟通技巧,增强患者的信任感,提高治疗依从性和改善医患关系,从而提升住院患者的治疗效果、满意度和体验感。Objective To summarize the essential elements of clinical doctors′ward rounds etiquette norms from the perspective of whether doctors′speech and behavior in actual ward rounds pay attention to patients′feelings and reflect humanistic care,in order to provide references for improving patients′treatment effects and medical experience management.Methods From July to October 2023,a purposeful sampling method was employed to select 16 clinical doctors with ward rounds experience from the eastern,central,western,and northeastern regions across the country.Semi-structured interviews were conducted online via video,focusing on issues related to etiquette norms during ward rounds.The Colaizzi′s seven-step analysis method was used to conduct an inductive analysis of the interview materials.Results four themes were distilled:friendly and caring body language;accurate,understandable,clear,and timely explanations;appropriate praise and affirmation to encourage patients to actively participate in their disease management;and admonitions to patients and their families regarding disease-related precautions.These four themes were summarized as the"four essentials of ward rounds,"which could be encapsulated as"altruistic inquiry;accurate explanation;affirmative engagement and adequate advice".Conclusions The"four essentials of ward rounds"can be made a mandatory part of the clinical doctors′workflow in the medical quality management process and are recommended for nationwide promotion.This can further enhance the communication skills of clinical doctors,strengthen patients′trust,improve treatment compliance,and improve doctor-patient relationships,thereby improving the treatment effects,satisfaction,and experience of inpatients.

关 键 词：卫生服务管理 临床查房 礼仪规范行为 Colaizzi七步分析法 医患沟通 人文关怀 

分 类 号：R47[医药卫生—护理学]