physician-patient relations

医患关系
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    文章类型: Journal Article
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  • 文章类型: Journal Article
    在日本,传统上,医患关系的特征是权力不平衡,这可能导致沟通差距。迄今为止,然而,在日本,患者的健康素养水平与他们对医生解释的医疗条件和治疗之间的联系尚未得到充分研究。
    这项研究的目的是调查患者的健康素养水平与他们对医生解释的理解之间的关联。
    这是一项横断面研究,分析了2021年7月从山形研究参与者收集的11,217份问卷中得出的数据。山形大学自2009年以来实施的一项基于社区的队列研究。
    结果显示,较低的健康素养与对医生解释的理解较差有关,调整潜在的混杂因素。除了健康素养低,与理解较低相关的因素是男性,没有正规的家庭医生,自我感知的健康和幸福水平较低。
    结果表明,医疗保健专业人员需要根据患者的健康素养水平与患者进行沟通,并确保他们充分了解自己的医疗状况和治疗方法。医疗提供者需要创造一个更好的健康知识环境,使患者和家庭能够自己做出决定。[HLRP:健康素养研究与实践。2024;8(3):e175-e183。].
    结论:我们调查了Yamagata研究参与者的健康素养与医生对医学解释的理解之间的关系。结果显示,较低的健康素养与对医生解释的理解较差有关。卫生保健提供者和组织在交流信息时,应考虑患者的健康素养水平,并确保患者充分了解他们的医疗状况和治疗。
    UNASSIGNED: In Japan, the doctor-patient relationship has traditionally been characterized by a power imbalance that may contribute to communication gaps. To date, however, the link between patients\' health literacy levels and their understanding of doctors\' explanations of medical conditions and treatment has yet to be fully examined in Japan.
    UNASSIGNED: The purpose of this study was to investigate the association between patients\' health literacy level and their understanding of doctors\' explanations.
    UNASSIGNED: This was a cross-sectional study analyzing data derived from 11,217 questionnaires collected in July 2021 from participants of the Yamagata Study, a community-based cohort study implemented by Yamagata University since 2009.
    UNASSIGNED: The results showed lower health literacy was associated with poorer understanding of physicians\' explanations, adjusting for potential confounding factors. In addition to low health literacy, factors associated with lower comprehension were being male, not having a regular family doctor, and having lower self-perceived levels of health and happiness.
    UNASSIGNED: The results suggest that health care professionals need to communicate with patients according to their health literacy level and ensure they fully understand their medical condition and treatment. Medical providers need to create a better health-literate environment to enable patients and families to make decisions by themselves. [HLRP: Health Literacy Research and Practice. 2024;8(3):e175-e183.].
    CONCLUSIONS: We investigated the relationship between health literacy and understanding of doctors\' medical explanations among participants of the Yamagata Study. The results showed lower health literacy was associated with poorer understanding of doctors\' explanations. Health care providers and organizations should consider their patients\' health literacy levels when communicating information and ensure that patients fully understand their medical condition and treatment.
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  • 文章类型: Journal Article
    本文讨论了英国国家卫生服务的两名医生如何描述和分析他们的工作条件:算法和协议如何构建他们可以提供的护理并创造他们和患者面临的困境。在这些问题上,NHS是当代西方医疗保健矿井中的金丝雀。NHS实践被理解为国家和类似国家的实体,Leviathans,寻求使他们的主题清晰;在这种情况下,通过标准化医疗工作和患者需求,使医生和患者对监督和管理透明可见。医生通过参与变通办法来回应,尽管有系统限制,但仍要寻找提供护理的方法。
    This essay discusses how two physicians in Britain\'s National Health Service describe and analyze the conditions of their work: how algorithms and protocols structure the care they can provide and create the dilemmas they and their patients face. In these issues, the NHS is a canary in the mineshaft of contemporary Western health care. NHS practices are understood as how states and state-like entities, Leviathans, seek to render their subjects legible; in this instance, to make both physicians and patients transparently visible to surveillance and administration by standardizing medical work and patient need. Physicians respond by engaging in workarounds, finding ways to provide care despite systemic restrictions.
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  • 文章类型: Journal Article
    作为医疗服务的补充,远程医疗对缓解我国卫生资源短缺具有重要意义。基于传统消费者行为测量模型的技术接受模式/计划行为理论(TAM/TPB),本文将在线患者信任分为六个维度:感知风险,个人信任倾向,医生的可信度,医院信誉,网站信誉,制度保障。在此基础上,采用结构方程模型(SEM)探讨在线患者信任各维度对在线患者意愿的影响,行为选择,和预先因素。共有582份有效问卷发放给有经验在医院及社区附近使用流动医疗服务的病人,以及在移动医疗网站的论坛上分享经验的用户。结果表明,在线患者信任对远程医疗行为意向选择具有显著的正向影响,标准化路径系数高达0.866。医生的可信度,制度保证,网站可信度对在线患者信任有显著的正向影响,标准化路径系数分别为0.401、0.260和0.226。医院可信度和个人信任倾向对在线患者信任没有显著影响。感知风险对在线患者信任有显著的负面影响,标准化路径系数为-0.118。研究结果表明,卫生部门和移动医疗提供商可以通过考虑患者的观点来增强移动医疗服务。提升他们的在线信任水平,并促进更深入的理解,安全意识,以及对远程医疗服务的信心。在此基础上,可以得出结论,只有政府的参与,医学科目,在线患者可以有效降低感知风险,改善在线患者的感知特征,增强在线患者信任,并促进在线医疗服务的真实意愿和行为选择,有效提高远程医疗在增加人们健康福利方面的积极作用。
    As a supplement to medical services, telemedicine is of great significance to alleviate the shortage of health resources in China. Based on the traditional consumer behavior measurement model the Technology Acceptance Mode/Theory of Planned Behavior (TAM/TPB), this paper divides online patient trust into six dimensions: perceived risk, personal trust tendency, doctors\' credibility, hospitals\' credibility, websites\' credibility, and system guarantee. On this basis, a structural equation model (SEM) was used to explore the influence of each dimension of online patient trust on online patient intention, behavior choice, and pre-factors. A total of 582 valid questionnaires were distributed to selected patients with experience in using mobile healthcare services in the vicinity of hospitals and communities, as well as to users who shared their experiences in the discussion forums of mobile healthcare websites. The results show that online patient trust has a significant positive impact on telemedicine behavior intention selection, with a standardized path coefficient being as high as 0.866. Doctors\' credibility, system guarantee, and website credibility have significant positive effects on online patient trust, with standardized path coefficients of 0.401, 0.260, and 0.226, respectively. Hospital trustworthiness and personal trust propensity have no significant effect on online patient trust. Perceived risk has a significant negative effect on online patient trust, with a standardized path coefficient of -0.118. The research findings suggest that health departments and mobile healthcare providers can enhance mobile healthcare services by considering the patients\' perspectives, elevate their online trust levels, and foster a deeper understanding, safety consciousness, and confidence in telehealth services. On this basis, it can be concluded that only the participation of government, medical subjects, and online patients can effectively reduce perceived risks, improve perceived characteristics of online patients, enhance online patient trust, and promote the real willingness and behavior choice for online medical services, effectively improving the positive role of telemedicine in increasing health benefits to people.
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  • 文章类型: Journal Article
    本系统综述旨在确定远程医疗中医患沟通的要素,新出现的挑战,并提出建议。四个数据库,包括科学直接,PubMed,科克伦,和ProQuest,使用系统评价和荟萃分析指南的首选报告项目进行搜索。纳入标准包括原始研究论文,提供免费全文,和过去10年的出版物。共有13篇文章完成了甄选过程,并符合既定标准。远程医疗通信的问题和建议分为三个不同的组:咨询前,在协商期间,和咨询后。准备包括视觉元素的安排,保护患者隐私和机密性,并解决可能出现的任何技术挑战。咨询包括非语言行为,同理心,医患关系,和体检。远程医疗后咨询是指在远程医疗会议之后进行的医疗预约,通常涉及后续医疗互动。远程医疗在医患咨询中提出了独特的挑战,不同于面对面的互动。因此,临床医生必须掌握远程医疗特定的沟通技能,以确保有效的咨询并获得最佳的健康结果。
    This systematic review aims to identify the elements of doctor-patient communication in telemedicine, emerging challenges, and proposed recommendations. Four databases, including Science Direct, PubMed, Cochrane, and ProQuest, were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria consisted of original research papers, availability of free full text, and publications during the past 10 years. A total of 13 articles completed the selection process and satisfied the established criteria. The issues and recommendations of telemedicine communication were categorized into three distinct groups: pre-consultation, during-consultation, and post-consultation. Preparation encompasses the arranging of visual elements, safeguarding patient privacy and confidentiality, and addressing any technical challenges that may arise. The consultation encompasses nonverbal behavior, empathy, the doctor-patient connection, and a physical examination. Post-telemedicine consultations refer to medical appointments that occur after a telemedicine session, typically involving follow-up medical interactions. Telemedicine presents unique challenges in doctor-patient consultations that differ from face-to-face interactions. Therefore, clinicians must acquire communication skills specific to telemedicine to ensure effective consultations and achieve optimal health results.
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  • 文章类型: Journal Article
    许多心理因素可能对个人的口腔健康和牙科治疗的成功有重大影响。总的来说,这些因素可能导致避免牙科就诊,紧急牙科预约,不顺从的牙齿行为,利用多个口腔保健提供者,口腔健康状况不佳。这些因素可能会影响个人的生活质量,并可能导致患者的不满,预后不良,和牙科治疗失败。多种心理因素可能会影响牙医和患者。这些因素可能会改变成功牙科治疗的预后。医生同理心是发展长期医患信任的基础。
    Many psychological factors may have a significant bearing on an individual\'s oral health and success of dental treatments. Overall, these factors may result in the avoidance of dental visits, emergency-based dental appointments, noncompliant dental behavior, the utilization of multiple oral health care providers, and poor oral health. These factors may affect the quality of life of individuals and may lead to patient dissatisfaction, poor prognosis, and failure of dental treatment. Multiple psychological factors may affect the dentist and the patient. Those factors may alter the prognosis for successful dental treatment. Physician empathy is fundamental in developing long-term physician-patient trust.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    本研究旨在调查知识,在马斯喀特三级医院的医生之间分享不愉快的健康信息和遵守SPIKES协议的态度和经验,阿曼。
    这项横断面研究于2022年8月至10月在苏丹卡布斯大学医院进行。一个电子,我们使用自编问卷收集来自不同科室医师的数据.
    共有89名医生完成了问卷(应答率=22.3%)。大多数参与者(n=86,96.6%)认识到需要在传递不愉快的健康信息(“坏消息”)方面进行额外的培训,78.7%(n=70)表示愿意接受此类培训。此外,32.6%(n=29)报告了由于坏消息传递不当而导致的负面经历,同等比例的人承认未经患者同意向他们的家人透露坏消息。大多数(n=77,86.5%)表现出对SPIKES协议的总体依从性高,59.6-85.4%,通常报告的12.4-34.8%和1.1-11.2%,有时,从不遵循协议的具体步骤,分别。婚姻状况(P=0.015)和资格(P=0.032)是唯一与依从性相关的变量。已婚医生和具有董事会和/或研究金证书的医生报告的依从性明显优于同行。
    阿曼的医生在提供令人不快的健康信息方面遇到挑战,强调文化影响的相互作用,培训和遵守协议。为了应对这些挑战,建议有针对性和频繁的培训计划,从本科医学教育开始,延伸到各种职业水平的医生的持续机会。
    UNASSIGNED: This study aimed to investigate the knowledge, attitude and experiences in sharing unpleasant health information and adherence to the SPIKES protocol among physicians at a tertiary hospital in Muscat, Oman.
    UNASSIGNED: This cross-sectional study was conducted at the Sultan Qaboos University Hospital from August to October 2022. An electronic, self-administered questionnaire was used to gather data from physicians across various departments.
    UNASSIGNED: A total of 89 physicians completed the questionnaire (response rate = 22.3%). Most participants (n = 86, 96.6%) recognised the need for additional training in the delivery of unpleasant health information (\'bad news\'), with 78.7% (n = 70) expressing their willingness to undertake such training. Additionally, 32.6% (n = 29) reported negative experiences due to improper delivery of bad news, with an equal proportion admitting to disclosing bad news to patients\' family without their consent. The majority (n = 77, 86.5%) demonstrated a high level of overall adherence to the SPIKES protocol, with 59.6-85.4%, 12.4-34.8% and 1.1-11.2% reported usually, sometimes and never following specific steps of the protocol, respectively. Marital status (P = 0.015) and qualifications (P = 0.032) were the only variables that were associated with adherence level, with married physicians and those with board and/or fellowship certificates reporting significantly better adherence compared to their counterparts.
    UNASSIGNED: Physicians in Oman encounter challenges in delivering unpleasant health information, underscoring the interplay of cultural influences, training and adherence to protocols. To address these challenges, targeted and frequent training programmes are recommended, starting from undergraduate medical education and extending to continuous opportunities for physicians at various career levels.
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