影响医患沟通的社会心理因素分析及对策研究

发布时间：2018-05-20 11:21

本文选题：医患沟通 + 心理因素　；参考：《广州医学院》2011年硕士论文

【摘要】：医患沟通作为人际沟通的特殊类型,在医患关系的形成、医患纠纷的发生、发展和解决有着重要影响。本研究以广州地区为调查点,通过自行设计的量表对医生、患者和社会公众三个群体进行“关于医患沟通的调查”,结论如下:①医生普遍压力过大,压力主要来源于工作任务重、责任大,同时社会对医疗行业的否定、患者及家属的不配合、工作待遇低、也构成了医生的压力来源。②诊疗过程中大部分患者表现出担心、焦急、敏感、多疑等负性情绪,相当部分患者的负性情绪未得到医生的安抚,对此医生和患者的评价之间存在差异,患者对医生服务的满意度偏低。③对于治疗方案制定者的选择,医生、患者和公众三方的意见不一。④医患双方对诊疗时间是否足够、医生解释病情的详细程度及医生是否确认解释的评价存在统计学意义上的差异,但总体而言,双方均认为诊疗时间不足够、解释病情不够详细、许多情况下医生未向患者确认解释。⑤双方均认为患者未完全听懂医生解释,并认为太多专业词汇是患者听不懂解释的主要原因。⑥医患双方对治疗失效的归因各不相同。针对以上结果,提出以下建议,从政策层面:①加大对医疗机构的投入;②健全基本医疗卫生制度;③进一步完善医疗保障制度;④建立医疗责任共担机制和保险制度;⑤建立并强制执行医务人员定期休假制度。从组织层面:①完善医院分配制度和奖惩机制;②完善医院危机管理策略;③建立缓解医生压力的长效机制;④加强医生医患沟通技能的教育和培训;⑤提供良好的就医环境;⑥保证患者充足的诊疗时间。从个人层面,对医生而言:①在诊疗过程中要了解并尊重患者需要,认真对待患者的反馈意见,避免自利归因;②要树立起正确的人生观、价值观、世界观,认识到医学和自身能力的局限性;③培养健康的生活方式,建立良好的社会支持系统。对患者而言:①需要正确看待医生和医学科学的作用;②提高科学文化素质,理性看待疾病状态;③理解医生的辛劳和压力。
[Abstract]:As a special type of interpersonal communication, doctor-patient communication plays an important role in the formation of doctor-patient relationship, the occurrence, development and resolution of doctor-patient disputes. Taking Guangzhou area as the investigation point, this study conducted a survey on the communication between doctors, patients and the public through a self-designed scale. The conclusions are as follows: Dr. 1 is generally under too much pressure. The pressure is mainly due to the heavy work tasks and heavy responsibilities. At the same time, the social negation of the medical industry, the lack of cooperation between patients and their families, and the low working conditions also constitute a source of pressure for doctors. 2. During the course of diagnosis and treatment, most patients show concern. Negative emotions such as anxiety, sensitivity, and paranoia are not appeased by doctors, and there are differences between doctors and patients. The patient's satisfaction with the doctor's service is on the low side. 3. The choice of the treatment plan maker, the doctor, the patient and the public have different opinions on whether the doctor and patient have enough time for the diagnosis and treatment, There were statistically significant differences in the degree of detail of the doctor's explanation of the condition and whether the doctor confirmed the explanation, but in general, both sides considered that the diagnosis and treatment time was not sufficient and the explanation was not sufficiently detailed. In many cases, doctors do not confirm the explanation to patients. 5 both sides think that patients do not fully understand the doctor's explanation, and think that too much professional vocabulary is the main reason why patients do not understand the explanation .6 the reasons for failure of treatment between doctors and patients are different. In view of the above results, this paper puts forward the following suggestions: to increase the investment in medical institutions from the policy level, to improve the basic medical and health care system and to further improve the medical security system. 4. To establish a medical responsibility sharing mechanism and an insurance system; Establish and enforce the system of regular leave for medical personnel. From the organizational level to improve the hospital distribution system and reward and punishment mechanism and improve the hospital crisis management strategy to establish a long-term mechanism to relieve the pressure of doctors (4) to strengthen doctor-patient communication skills education and training to provide a good medical environment; Ensure adequate time for diagnosis and treatment of patients. At the personal level, to the doctor, in the process of diagnosis and treatment, the doctor should understand and respect the needs of the patient, take the patient's feedback seriously, avoid self-interest attribution and establish a correct outlook on life, values, and world outlook. Recognize the limitations of medicine and ability to develop a healthy lifestyle and establish a good social support system. To the patients, the role of doctors and medical science should be regarded correctly and the scientific and cultural quality should be improved, and the state of illness should be viewed rationally. (3) to understand the hard work and pressure of doctors.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R395

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