In recent two decades, the incidence and severity of medical disputes have been dramatically increasing in China which has a negative influence for patients, doctors and hospitals. It must be seriously regarded that 80% of the medical disputes are caused by the bad attitude of health care professionals, ethical problems, and poor communication skill with patients. Chinese health care professionals should be aware of how to establish a good doctor-patient relationship. The development of evidence-based medicine (EBM) will help us bridge a gap between medical science and clinical practice, revise our opinions, update our knowledge and improve our service. Cooperation with the Chinese Evidence-Based Medicine Center (CEBMC), and the Chinese Medical Doctor Association (CMDA) will help doctors practice legally and in an evidence-based manner so as to protect both rights of patients and doctors.
目的 调查医疗文书填写现状并探讨其对患者满意度之间的影响。 方法 2012年10月－12月以呼吸内科住院的患者为调查对象，调查其医疗文书完成情况，统计医疗文书缺项数目。同时参考国内外患者满意度研究，自制满意度调查表，调查患者对医务人员满意度；分析医疗文书缺项数目对患者满意度的影响。 结果 研究共纳入151例患者，共有126份医疗文书存在不同程度填写缺陷，占83.44%，平均缺项（11.58 ± 11.63）条。总体患者就医满意度为6.85分，与医疗文书缺项数目呈现负相关性（R=?0.602，P=0.001）。患者性别、年龄、文化程度、付费方式和住院天数与患者满意度无相关性。 结论 医疗文书缺项数目较多、完成质量不高。需要加强医务人员对于医疗文书完成质量的重视程度。
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 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 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 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.