| Objective In recent years,the doctor-patient relation has become unstable,sometimes even tense,which leads toconflicts and cases of killing medicalstaff.One of the reasons is the crisis between doctors and patients and communication obstacle is the first factor to cause the crisis.According to the survey,more than 80% medical disputes have been caused by medical ethics,language communication and service attitude.Obviously,good communication will be helpful in reducing the doctor-patient disputes and improving medical occupation accomplishment and satisfaction rate of patients.It is the military hospitals’ responsibility to help and serve the people.However,with the development and the great change of the society,the doctor-patient communication in military hospitals has met huge challenge.This research has been carried out in order to find the countermeasures to improve the communication through the comprehensive survey.Methods 1.Study objects We conducted the first convenient sampling survey of both doctors and patients of 300 cases in 3 military large-scale comprehensive hospitals.The including criteria for the survey are informed consent,patient’s condition permits,junior high school education or above and no mental illness and cognitive impairment.At last,286 cases of doctors and 276 cases of patients are used as effective questionnaires.We conducted the secondconvenient sampling survey of hospitalized patients of 300 cases in the same hospitals.The survey included doctor-patient communication skills,content,trust and satisfaction.At last,284 cases are used as effective questionnaires.2.Questionnaire design In the first round ofquestionnaire,from doctor’s perspective,the questionnaire of doctors includes basic information,doctor’s cognition of doctor-patient communication,doctor-patient communication status quo,skills and content,reasons for doctor-patient relationship tension,influencing factors of communication and improving countermeasures.From patient’s perspective,the questionnaire of patients includes patient’s cognition of doctor-patient communication,doctor-patient communication status quo,skills and content,expression methods of discontent in medical staff,influencing factors of communication and improving countermeasures.In the second round ofquestionnaire,basic information,doctor-patient communication skills,content,trust and satisfaction were gathered.3.Statistical methods Descriptive statistical analysis,variance analysis,correlation analysis and hierarchical regression analysis were done through SPSS22.0.Results 1.Cognitive Analysis of the Doctor-patient Communication 2.Cognition of the status quo of doctor-patient Communication3.Cognition of communication skills Doctors’ questionnaires showed that 67.1% people regarded that communication should be done patiently;90.9% people chose simple words;58% people liked to talk slowly,53.8% speak in moderate volume and 37.1% communicate smoothly;73.4% people chose at least two methods or more.54.5% people thought external image had great influence and 45.5% people general influence.58% people had eye contact frequently,36% people occasionally,3.5% people rarely and 2.4% people had no attention on it.Patients’ questionnaires showed that 16.3% people thought that external image had no influence,46.7% people general influence and 37% people great influence.4.Cognition of communication content 89.9% doctors talked about physical condition,treatment plan and prognosis,73.1% people cost,82.9% people health education,35% people family topics or common interests,0.7% people something else,and 83.9% people chose two kinds or more.96.7% patients liked to talk about physical condition,treatment plan and prognosis,44.6% people cost,29.3% health education,13.8% family topics or common interests and 1.1% people something else.5.Cognition of communication obstacles 91.3% medical staff thought that the obstacles arose due to busy work and time limits,69.9% people lack of the attention and skills,35% people bad medical ethics,32.9% people lack of expertise;8.7% people thought doctors had no responsibility for obstacles.75.9% medical staff chose two kinds or more.Moreover,86% medical staff regarded that patients had little understanding of medicine;88.1% medical staff thought that patients’ expectation was too high to meet;76.9% medical staff thought patients had no trust in medical staff;55.2% medical staff regarded that patients had low level educational cultivation;31.1% medical staff thought that patients had little desire for communication;30.8% medical staff regarded that patients had no responsibility for the obstacles;90.9% medical staff chose two kinds or more.82.6% patients thought that communication obstacles were caused by doctors’ busy work and time limits;38.4% patients chose bad medical ethics;13% patients chose the lack of expertise;34.1% patients thought that medical staff had not attached great importance to the communication and were in lack of communication skills related;8.3% patients regarded that medical staff had no responsibility for the obstacles.Moreover,82.6% patients thought they had little medical knowledge;42.8% patients thought their expectation were too high;23.9% patients had little trust in medical staff;30.1% patients had little expectation to communicate;10.5% patients thought they had no responsibility for the obstacles.6.Cognition of strengthening communication between doctor and patient 82.5% people chose that the government should formulate appropriate policies;60.5% people chose to strengthen the administration of hospitals;76.9% people thought the medical staff should strengthen communication with patients;67.1% chose the cooperation of patients and relatives;82.2% chose to work together.88.1% people chose two kinds or more.7.Cognition of current situation of nurse-patient communication Generally speaking,the communication qualification was comparatively high and the mean value reached 4.4008;The communication skills were comparatively good and the mean value reached 4.358;The communication content was comparatively rich and the mean value reached 4.4437;The trust and satisfaction were comparatively high and the mean value reached 4.2946 and 4.3063 respectively.Conclusion Most of the medical staff and patients have realized the importanceof communication.The communication skills and content are rich and high level satisfaction exists in military large-scale comprehensive hospitals.Both medical staff and patients are aware of shortcomings of both sides.Suggestions: It is the duty for the country to improve the policy and better legal construction to protect the rights and interests of both doctors and patients.It is the responsibility for the medical system to strengthen the humanistic training of medical staff.It is the duty for the society to spread the basic knowledge of medicine.It is the responsibility for the hospitals to make reasonable arrangements for medical staff working hours.It is the duty for the medical staff to improve medical ethics,communication skills.It is the responsibility for the patients to increase public health knowledge.In conclusion,all sides should work together to make the communication better. |
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