老年综合评估在医患沟通教学中的应用研究

doi:10.3760/cma.j.issn.1673-677X.2019.05.017

中华医学教育杂志 ›› 2019, Vol. 39 ›› Issue (5): 391-396.DOI: 10.3760/cma.j.issn.1673-677X.2019.05.017

老年综合评估在医患沟通教学中的应用研究

杨茜岚¹, 鲁翔², 冯美江¹, 曲晨¹, 余真¹, 郦俊华³, 何慧薇¹

¹南京医科大学第二附属医院老年医学科 210011;
²南京医科大学 211166;
³南京医科大学第二附属医院教学办 210011

收稿日期:2018-10-11 发布日期:2020-12-11
通讯作者: 何慧薇,Email:hehuiwei1020@hotmail.com,电话:025-58509728
基金资助:
南京医科大学“十三五”教育研究课题(QN2017155);南京医科大学科技发展基金重点项目(2017NJMUZD035)

Application of comprehensive geriatric assessment in the teaching of doctor-patient communication

Yang Xilan¹, Lu Xiang², Feng Meijiang¹, Qu Chen¹, Yu Zhen¹, Li Junhua³, He Huiwei¹

¹Geriatric Department, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China;
²Nanjing Medical University, Nanjing 211166, China;
³Teaching office, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China

Received:2018-10-11 Published:2020-12-11
Contact: He Huiwei, Email: hehuiwei1020@hotmail.com, Tel: 0086-25-58509728
Supported by:
Nanjing Medical University “the 13th Five-Year Plan” Education Research Project (QN2017155) ; Nanjing Medical University Science and Technology Development Fund Key Project (2017NJMUZD035)

摘要/Abstract

摘要： 目的评价老年综合评估在医患沟通教学中的应用效果。方法选取2017年7月~2018年6月在南京医科大学第二附属医院实习的南京医科大学2013级临床医学专业187名学生为研究对象。以简单随机抽样法将研究对象分为实验组与对照组。实验组借助老年综合评估量表实施医患沟通教学。对照组实施传统的医患沟通教学。实习前后应用医患沟通量表分别对两组学生医患沟通能力进行评估。结果教师对学生进行的医患沟通能力评价结果显示,培训后实验组学生在医患关系建立[3(3,4)分比2(1,3)分]、信息采集[4(4,4)分比2(1,3)分]、信息给予[4(3,4)分比2(1,3)分]、理解患者[3(3,4)分比2(2,3)分]、结束问诊能力[3(3,4)分比2(2,3)分]方面较培训前明显提高,且均优于对照组学生[3(2,4)分、2(2,3)分、3(2,4)分、3(2,3)分、3(2,3)分],差异均具有统计学意义(均P<0.01)。患者或陪护人员的评价结果显示,实验组学生在尊重[4(4,4)分比4(3,4)分]、启示兴趣[4(3,4)分比3(3,4)分]、鼓励提问[4(3,4)分比4(3,4)分]、采用通俗易懂语言[4(3,4)分比3(3,4)分]及总分[22(21,23)分比21(19,23)分]优于对照组学生,差异均具有统计学意义(均P<0.01)。学生自我评价结果显示,实验组学生信息传递[4(3,4)分比3(2,3)分]、情感交流[4(3,4)分比3(3,4)分]及总分[14(14,15)分比14(13,14)分]优于对照组学生,差异均具有统计学意义(均P<0.01)。结论在实习教学中应用老年综合评估可以提高学生医患沟通能力,为优化医患沟通教学改革提供了新的思路。

关键词: 老年综合评估, 医学生, 医患沟通

Abstract: Objective To evaluate the application effect of comprehensive geriatric assessment in the teaching of doctor-patient communication. Methods Totally 187 clinical medical students of Grade 2013 Nanjing Medical University who were interned in the Second Affiliated Hospital of Nanjing Medical University from July 2017 to June 2018 were selected as subjects. The students were randomly divided into experimental group and the control group by simple random sampling methods. The experimental group joined in the comprehensive geriatric evaluation for the teaching of doctor-patient communication, while the control group was given traditional teaching. Before and after the internship, the communication abilities of the two groups of students were assessed. Results The evaluation results of doctor-patient communication ability from teachers showed that the experimental group had significantly higher scores in establishing the doctor-patient relationship [3(3,4) vs 2(1,3)], gathering information [4(4,4) vs 2(1,3)], giving information [4(3,4) vs 2(1,3)], undersanding patients [3(3,4) vs 2(2,3)] , and ending inquiry ability [3(3,4) vs 2(2,3)] before the training, and had significantly higher scores than those [3(2,4), 2(2,3), 3(2,4), 3(2,3), 3(2,3)] in the control group (all P<0.01). Patients or accompanying staff assessed that students in the experimental group had significantly higher scores in respect [4(4,4) vs 4(3,4)], inspiration interest [4(3,4) vs 3(3,4)], encouragement of questioning [4(3,4) vs 4(3,4)], easy-to-understand language [4(3,4) vs 3(3,4)] and total scores [22(21,23) vs 21(19,23)] than those in the control group(all P<0.01). Students self-evaluation showed that medical students in the experimental group had significantly higher scores in information transmission [4(3,4) vs 3(2,3)], emotional communication [4(3,4) vs 3(3,4)] and total score [14(14,15) vs 14(13,14)] than those in the control group (all P<0.01). Conclusions The application of comprehensive geriatric assessment could improve students' ability of doctor-patient communication and provide new ideas for optimizing the teaching reform of doctor-patient communication.

Key words: Comprehensive geriatric assessment, Medical student, Doctor-patient communication

中图分类号:

R-05

杨茜岚, 鲁翔, 冯美江, 曲晨, 余真, 郦俊华, 何慧薇. 老年综合评估在医患沟通教学中的应用研究[J]. 中华医学教育杂志, 2019, 39(5): 391-396.

Yang Xilan, Lu Xiang, Feng Meijiang, Qu Chen, Yu Zhen, Li Junhua, He Huiwei. Application of comprehensive geriatric assessment in the teaching of doctor-patient communication[J]. Chinese Journal of Medical Education, 2019, 39(5): 391-396.

参考文献

[1]Diamond-Brown L. The doctor-patient relationship as a toolkit for uncertain clinical decisions[J]. Soc Sci Med, 2016, 159:108-115. DOI: 10.1016/j.socscimed.2016.05.002.
[2]Valluri KA. Web exclusives. Annals graphic medicine: Today's doctor-patient relationship[J]. Ann Intern Med, 2016, 165(7):W12. DOI: 10.7326/G16-0014.
[3]Riedl D, Schüßler G. The influence of doctor-patient communication on health outcomes: A systematic review[J]. Z Psychosom Med Psychother, 2017, 63(2):131-150. DOI: 10.13109/zptm.2017.63.2.131.
[4]陈旭娇, 严静, 王建业, 等. 老年综合评估技术应用中国专家共识[J]. 中华老年医学杂志, 2017, 36(5): 471-477. DOI: 10.3760/cma.j.issn.0254-9026.2017.05.001.
[5]Makoul G. The SEGUE framework for teaching and assessing communication skills[J]. Patient Educ Couns, 2001, 45(1):23-34.
[6]Lipner RS, Blank LL, Leas BF, et al. The value of patient and peer ratings in recertification[J]. Acad Med, 2002, 77(10 Suppl): S64-66.
[7]Cegala DJ, Coleman MT, Turner JW. The development and partial assessment of the medical communication competence scale[J]. Health Commun, 1998, 10(3):261-288. DOI: 10.1207/s15327027hc1003_5.
[8]王锦帆. 医患沟通学课程教学新模式探索[J]. 中华医学教育杂志, 2007, 27(6): 30-32.
[9]Renaud JS, Côté L. Validation of the 5-item doctor-patient communication competency instrument for medical students (DPCC-MS) using two years of assessment data[J]. BMC Med Educ, 2017, 17(1):189. DOI: 10.1186/s12909-017-1026-9.
[10]赵勋, 何启瑜, 覃子健, 等. 高校学生对医患关系及其影响因素认知的调查[J]. 中华医学教育杂志, 2018, 38(4): 519-522. DOI: 10.3760/cma.j.issn.1673-677X.2018.04.010.
[11]谷士贤, 张爱京, 霍刚, 等. 医患沟通技能评价表在住院医师规范化培训中的应用[J]. 中华医学教育杂志, 2018, 38(3): 435-438,454. DOI: 10.3760/cma.j.issn.1673-677X.2018.03.027.

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老年综合评估在医患沟通教学中的应用研究

Application of comprehensive geriatric assessment in the teaching of doctor-patient communication

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