解决患者与医生的关系中的分歧:改善管理护理中的沟通工具
W Levinson1, R Gorawara-Bhat, R Dueck
1Section of General Internal Medicine and Program for Physician Patient Communication Research, University of Chicago, Ill 60627, USA. wendy@medicine.bsd.uchicago.edu
JAMA
|October 27, 1999
概括
管理护理管理的护理.
科学领域:
- 医疗保健管理的管理
- 医学伦理 医学伦理
- 患者与医生的沟通 患者与医生的沟通
背景情况:
- 管理护理采用财务激励和利用限制,影响医生的决策和医疗保健成本.
- 由于对医生的客观性和对患者护理的财务影响的担忧,公众的信任正在被侵蚀.
- 这些因素在患者与医生的关系中可能造成冲突.
研究的目的:
- 识别和阐明患者与医生关系中出现的因管理护理而产生的分歧.
- 探索具体的情景,说明与资源分配,患者获取和财务激励相关的冲突.
- 提出沟通和政策策略,以缓解这些分歧.
主要方法:
- 1998年10月召开了一个多学科小组,包括患者代表,医疗保健领导人,医生,沟通专家和伦理学家.
- 分析了三个不同的场景:资源分配 (转介变化),患者获取 (提供者选择) 和财务激励 (订购测试).
- 为医生制定沟通策略,为健康计划/团体制定政策建议.
主要成果:
- 确定了由管理护理实践产生的患者与医生冲突的关键领域.
- 通过具体的,可联系的场景来说明潜在的分歧.
- 创建可操作的沟通策略,以改善管理护理下的患者与医生的互动.
结论:
- 有效的沟通策略可以帮助医生解决与管理护理相关的冲突.
- 医疗保健计划和医生团体可以实施政策,以减少患者和医生的分歧.
- 解决这些问题对于在管理护理系统中保持信任和最佳的患者护理至关重要.
相关概念视频
Communication
Communication between two animals occurs when one animal transmits an information signal that causes a change in the animal that receives the information. Organisms communicate with one another in a host of different ways. Signals can be auditory, chemical, visual, tactile, or a combination of these. Communication is a critical behavioral adaptation that promotes survival, growth, and reproduction.
Communication
Sharing information, concepts, and emotions to foster mutual understanding is communication. The sender, recipient, and transaction must be considered in this manner. The sender is the person who shares the message, the recipient is the person who receives and understands the message, and the transaction is the method used to deliver the message and the variables that affect the communication's context and surroundings. The nurse-client connection is built on therapeutic communication.
Within...
Within...
Techniques of Therapeutic Communication II: Focusing, Paraphrasing, and Summarizing
Focusing involves centering a conversation on a message's critical elements or concepts. Focusing is valuable if the talk is vague or patients begin to repeat themselves. Sometimes, when patients are asked about their symptoms, they may go off-topic and try to tell their entire life story. Respectfully, the nurse should bring the conversation back into focus.
This therapeutic technique can also be used when a patient brings up pertinent information during a health-related conversation. The...
This therapeutic technique can also be used when a patient brings up pertinent information during a health-related conversation. The...
SBAR II: Application of SBAR
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
Barriers to Effective Communication II
The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Ethical Dilemmas II
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:


