| Background:Along with the progress of the society, the national quality continuously improve and people’s consciousness for self health care grow gradually, the recommend of people for quality of life health become more to high, the contradiction between the shortage of medical and health services resources in China and the high demand for the health is becoming more and more prominent, the medical and health cause problems become one of the most important China’s social development in the construction of the people’s livelihood, it not only relates to hundreds of millions of family life and happiness, and at the same time, involved1.3billion people’s medical problems related to social political and economic life of each corner, therefore, in our country whatever a tiny medical problems can draw wide attention from all social aspects, in our country, the problem existing in medical service system such as "difficult&expensive to see your doctors" emerges gradually, in recent years, With the continuous development of medical enterprise, the people’s legal consciousness also continuously improve, the relationship between doctors and patients, relation seems the fish in water in the past have become more and more nervous, medical disputes and battered hospital events happened more frequently, many medical staffs life has been threaten and damaged, doctor-patient contradiction becomes violent.At present the widespread phenomenon in the medical industry of our country is: on the one hand patients suffers diseases, on the other hand patients also undertake great psychological pressure, but also face the high medical costs; however, as the hospitals make efforts to reduce medical disputes, it is bound to take defensive medical strategies, dare not to start a new technology or new projects, and medical service improve slowly, thus greatly reduces the patients’satisfaction, correspondingly, medical disputes also emerge endlessly as focus of attention.As we all know, our country’s medical resource is in great short, and people have a great demand of health quality, thereby, the foundation of good doctor-patient communication become an effective methods to solve medical disputes. And it can help the patients understand the correct medical information, make decisions related to the treatment and avoid the risk, even if unsatisfactory results appeared, it can also help the patient and family correctly understand rationally.Objective:To explore the influential factors on doctor-patient communication, we carry out investigation in a Grade IIIA hospital which obey the standard doctor-patient communication, by sending questionnaire to patients and doctors, to find out the basic knowledge of both sides, the present situation of doctor-patient communication, the problem existing in the process and the influential factors of Doctor-patient Communication, provide a scientific basis for decision-making to improve the effectiveness of doctor-patient communication.Method:Using random sampling analysis method, we make targets at physician medical care personnel and patients and family members in specialized department of this hospital.This study survey questionnaire refer to the SEGUE Framework which is edited by Gregory Makoul, and refer to some other literature, as well as the special conditions of this survey, we also consult the relevant experts, and make the final revision after preliminary investigation. From2011.12to2012.4, we put388questionnaires in a Grade IIIA hospital,220to patients and168to doctors, through analysis, we aim to know the situation of doctor-patients communication to find out the influential factors. The questionnaire conclude such contentions:the knowledge, information, skills of doctor-patients communication, the basic conditions of objectives, as well as the appraisal of doctor-patients communication.Then we use Epidata3.0to build the data foundation, All materials go through strict review, and all data should entry twice by two different personnel, and we make consistency check to the two database. And we use SPSS16.0to make statistics, analyzing the evaluations of patients and doctors on relationship between the two parts as well as the influential factors.Results:1.Reliability&Validity of Questionnaire testFrom the correlation, the dimensions of this questionnaire between the correlation coefficient is less than0.7. doctor-patient communication information dimension scores and doctor-patient communication skills dimension scores and the total score correlation coefficient are greater than0.8which is more ideal. Questionnaire internal reliability is mainly analysis Krona Bach coefficient, each dimension of Krones Bach coefficient are greater than0.6, explain this questionnaire dimensions of the correlation of internal entry is good, and the internal reliability is better.2.The basic situation of the research objectsThis research mainly focus on the each physician department, and recycle the valid questionnaires:168from the doctor, and220from patients. According to statistics, of the medical personnel,74are male,94are female; middle-aged give majority to the whole population, most of medical personnel own master and PhD degree. Of patients and patients in the family,118are male,102are female; old-age is in the majority, and the cultural level of which is relatively low.3through the analysis of the factors affecting doctor-patient communication, both doctors and patients have similar overall understanding on the doctor-patient communication, but on the specific content they have slightly differentness:Doctor-patient communication cognitive:the importance of doctor-patient communication, the effect of doctor-patient communication, the reliability of doctor-patient communicationDoctor-patient communication information:the content of doctor-patient communication, the frequency of doctor-patient communication, and the attitude of doctors in doctor-patients communication.Doctor-patient communication skills:whether the medical personnel’s image and etiquette have an impact on the communication between doctors and patients.Influence factors of doctor-patient communication:analysis from both the medical personnel and the patients.In the face of doctor-patient communication what measures are to be taken:active explain, inactive or avoidance, or to take their own way to solve.Other:whether to accept a formal humanities education.Results:1. Doctors and nurses share the same general understanding in the influence factors of doctor-patient communication.2. As for present situation of doctor-patient communication, both doctors and patients have the similar overall knowledge, and both sides weigh doctor-patient communication is very important, on the frequency of doctor-patient communication they met on the same, but the patients and their family members think that the effect of doctor-patient communication is not good, the both sides have the same general understanding on whether they trust the medical staff, but absolutely faith rate is not high.3. doctors’and patients’appraisal exist differences on doctor-patient communication skills and cognitive evaluation, patients pay more attention to doctor-patients communication skills than the doctor, and the doctor believe their communication skills is fair enough, which is still a long distance away from the expectations of patients.4. the doctor-patient communication is influenced by many factors, medical personnel think the main factors are the shortage of health care, restricted work time; The existing main factors of patients and family members account for medical knowledge shortage and the expectation too much to satisfy.5. when conflict occurs to doctor-patient communication, medical staff use more active methods to solve the problem, patients and family members often take inactive or avoiding attitude.6. And most of the medical personnel all received psychology medical ethics, such as humanities education, but there are still a third of the medical personnel only partially to accept or not to accept a humanistic education.Solutions&Suggestions:1. Good doctor-patient relationship begins from the good doctor-patient communication. Doctor-patient communication should make the patients as the center, reduce the patient psychosomatic pain, create the best psychosomatic status needs, and promote the understanding and support between patients and doctors, to enhance the treatment effect.2. To make the humanized service as the center, looking for new possible service. The hospital should learn how to respect, understand and care patients, seek new service point, through the humanized service we could improve the doctor-patient relationship measures, improve the satisfaction of the patients.3. To ensure doctor-patient communication channels clear, in the doctor-patient relationship, medical personnel always stand in active point, while patients always at passive position, so the hospital should always grasp the initiative time to have a definite object.4. Improvement of the medical service quality is the premise of the communication, the medical service quality depends not only on the medical personnel’s technical level, medical morality, medical facilities, in addition, a important aspect is the patients cooperation and support, to get the patients cooperation and support, the hospital will strengthen the communication with patients and family members, so that they can be aware of disease diagnosis and treatment scheme and the cost somewhat.5. Pay great attention to the patients psychological, as medical care part, when make diagnosis and treatment, they should be calm. Also they should pay attention to the psychological counseling for patients, and to ensure patients understanding cooperation between the patient and reduce misunderstanding, clear the psychological obstacle, formed the common understanding, this is also one of the important contents of psychological treatment.6. Pay attention to doctor-patient communication skills, in the medical work, some medical staff and patient never contradict, and others often have conflict from time to tome, this is the language communication skills and mentality problem of doctor-patient communication. Language skills is very important, involves the doctor’s basic quality, carefully observation, patient listening, alert talk, warm encourage and serious interpretation skills.7. Pay attention to medical staff image and etiquette, hospital environment, medical personnel’s instrument can give the patients first impression, beautiful environment increase comforts, medical personnel’s appropriate title for patients is to establish good communication beginning.8. Provide consummate quality technical service, let the patients assured, as the people’s living standard improved, the patients’demmands for the medical service also develop along with it, coupled with the continuous development of human disease patterns changes, this does not only require medical staffs’good service attitude, and also superb medical technology, and the use of modern scientific new knowledge new results new technology, with all kinds of human diseases of the struggle with high exquisite leech craft relieve patients pain. |
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