Objective To seek the best evidence on communication between physicians and patients so as to improve the physician-patient relationship in China. Methods We used the key words ‘physician-patient relationship’ and ‘communication’ to identify related systematic reviews and meta-analyses, and then evaluated them with the Overview Quality Assessment Questionnaire (OQAQ) checklist. Results Seventeen studies were included for final evaluation. According to the OQAQ checklist, the score range of the study quality was 3 to 9. 41.29% (7/17) of the included studies scored 7 to 9, 23.5% (4/17) scored 6, and 35.3% (6/17) scored 3 to 5. Factors influencing physician-patient communication primarily included communication targets, time, contents, and approaches. Conclusion There are not enough studies on physician-patient communication in China. We need to identify the problems affecting communication behavior, encourage patients to express their preferences, choose appropriate training strategies, and make timely evaluation so as to better satisfy the needs of patients and physicians.
目的:调查在校医学生对医疗相关法律法规及医患关系的认知,为医学生教育提出建议。方法:使用自制调查问卷,对四川大学华西校区不同专业方向及学历层次的在校医学生进行整群随机抽样,将所得数据录入计算机建立数据库,进行统计分析。结果:(1) 在对医疗法规相关知识的知晓率上,研究生高于本科生,临床相关专业高于非临床相关专业;(2) 医学生对医疗法规相关知识及医患关系的认知主要来自于课外,来自于课堂教学的很少,并且大多数医学生支持开设相关法律课程;(3) 过半数的医学生认为医患沟通不足是导致医疗纠纷的首要原因;(4) 大多数医学生认为目前医患之间存在信任危机,且这种状况对他们今后的择业观造成了负面影响。结论:在医学生中开展相关医疗法律课程等人文学科课程是符合当前国内医疗卫生事业发展需要的。
Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
The relationship between doctors and patients becomes a public hot topic recently, which becomes more prominent during the reforming and transition of the health care system. The emergence of evidence-based medicine corresponds to the requirement of the clinical practice brought by the transition of the health care system. It will play an important role in improving the relationship between doctors and patients. The promotion of evidence-based practice will be helpful to alleviate the conflict between doctors and patients and to increase the quality of health care.
Objective To explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 566 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous selfadministered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. The patients’ biggest concerns were: treatment effect, cost and doctors’ skills. The biggest difficulties that patients worried about were: long-time waiting in out-patient departments and limited time to communicate with doctors. Conclusion As more and more patients would like to involve in shared decision-making, doctors need to provide patients with more choices and help them make a right decision in their treatment.
The increasing deteriorative trend of doctor-patient relationship (DPR) have destroyed patient safety, doctor safety and social stability in China. DPR is a complicated social problem related to multidisciplinary and multi-factor interactions. A series of researches providing different views on how to improve DPR in China have been published in recently years. Evidence-based medicine (EBM) aims to deal with massive information by producing, synthesizing and disseminating evidence from complex interventions. We tried to explore the trait of DPR by EBM methods. We provided evidence on research trends, topics and methods by systematic database retrieval, classification by screening, and quality assessment. Through dissection, attribution, and visualization of interactions and relationships between factors, we provided an evidence-supported framework for improvement of DPR. We identified gaps, defects or deficiencies in existing research, and promoted further research. We continued to follow up the research and faced a challenge: Reflection and frustration in the process of establishing the quality evaluation system of qualitative research. We found that the study of complex humanities and social sciences by reference to evidence-based methodology might be: providing a structured, panoramic perspective for complex social problems on " de-fragmentation”, providing a framework for social governance through classification and hierarchy, and calling for a more tolerant attitude and more comprehensive application of methodologies.