如何在临床咨询中介绍和讨论风险
Cordet Smart1, Hannah Cock2, Phil Tittensor3
1Director of Professional Doctorates and Clinical Associate Psychology, Exeter University, United Kingdom.
讨论的风险,如突然意外死亡 (SUDEP) 是一个挑战. 临床医生应根据患者的理解进行风险讨论,但为了更好地管理风险,通常更喜欢直接性.
科学领域:
- 神经学
- 医疗沟通
- 质量研究
背景情况:
- 的不良影响,包括伤害,抑郁和突然意外死亡 (SUDEP),可以通过患者控制的因素减轻.
- 新的指导方针建议在诊断时讨论风险, 但临床医生由于潜在的患者焦虑而犹.
研究的目的:
- 分析专家如何与专家诊所的患者讨论风险.
- 了解这些敏感对话中使用的沟通策略.
主要方法:
- 在英格兰的专家诊所对24个初次电话预约的分析.
- 包括一个案例研究和与临床医生,研究人员和患者的联合分析会议.
主要成果:
- 冒出风险是敏感和复杂的, 涉及谈判和解决患者的困惑.
- 临床医生使用质疑和"修复暗示"技术来建立相互主观性.
- 在这些讨论中,认识因素 (谁知道什么) 是至关重要的.
结论:
- 临床医生经常使用患者的知识作为讨论行为改变的基础,避免直接提到严重的风险.
- 这种方法可能会导致互动困难,患者更喜欢直接沟通.
- 精心校准风险信息和直接性是患者参与风险管理的关键.
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