这不是关于赢或输:顾问如何在严重疾病中导航分歧
Mary E Callahan1, Jesse A Solomon2, Taya R Cohen3
1Assistant Professor of Medicine, Adult Palliative Care Service, Department of Medicine, Columbia University Medical Center, New York, NY, USA.
Journal of pain and symptom management
|February 11, 2026
概括
咨询医生经常与分歧作斗争,将其解释为个人攻击. 沟通和视角培训可以为研究员提供必要的技能,以有效地应对这些具有挑战性的情况.
科学领域:
- 医疗教育 医学教育
- 临床传播 临床沟通
- 医疗保健的不平等 医疗保健的不平等
背景情况:
- 咨询和初级临床医生之间的分歧在严重疾病护理中很常见.
- 临床医生发现这些分歧令人不安,但最佳的准备策略仍然不清楚.
研究的目的:
- 探索咨询医生 (同事和护理人员) 对不同意见的经验.
- 识别可以改善医生在医生之间分歧的导航能力的技能.
主要方法:
- 与研究员和临床医生进行了半结构化采访,涉及息治疗,脏病学和胃肠病学.
- 两个独立的调查人员使用了诱导性主题分析来分析采访数据.
主要成果:
- 被认为是负面的分歧往往被解释为对专业知识或身份的挑战,特别是受训人员.
- 与同学不同的是,主治医生优先考虑与决策一起建立关系的沟通,而不是同学.
- 医生发现直接沟通和承认对方的观点是富有成效的.
- 报告说,在分歧航行方面的正式培训很少;技能主要是通过经验获得的.
结论:
- 咨询专业的研究员觉得自己没有准备好处理与初级临床医生的分歧.
- 临床医生在沟通,建立关系和采取视角方面拥有经验技能,这些技能可以正式教授给研究员.
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