全科医疗咨询过程中培养和维持患者的信任：戒烟建议案例
2010/02/03
目的：本文旨在描述全科医疗咨询过程中如何培养和维持患者信任，及其与戒烟建议之间的关系。
方法：本试验包括6名丹麦全科医生与11名患者关于医学咨询观察结果而进行的访谈。
结果：结果显示，全科医生和患者都希望全科医生能与患者产生互动，评价及解决患者的健康问题。同时患者还希望全科医生能向患者显示其已了解患者的健康问题。全科医生和患者都感觉这样有助于培养患者对医生的信任。咨询时提供的戒烟建议能显示出医生渴望为患者提供帮助，从而使患者对全科医生产生信任。
结论：戒烟建议有助于培养及强化患者信任。戒烟效果有赖于建议是否符合患者和全科医生在医疗咨询互动过程中的期望。
应用价值：在给予戒烟建议时，为培养和维持患者的信任，全科医生应考虑患者与医生互动交流时的具体期望。
（刘国梁 审校）
Patient Educ Couns. 2010 Jan;78(1):46-52. Epub 2009 Jun 7.
Developing and maintaining patients’ trust during general practice consultations: the case of smoking cessation advice.
Guassora AD, Gannik D.
The Research Unit and Department of General Practice, University of Copenhagen, Denmark.
OBJECTIVE: The aim of this paper is to describe how the process of developing and maintaining trust is related to how and if smoking cessation advice is given in general practice consultations.
METHODS: The study consisted of interviews with six Danish GPs and with 11 of their patients, on the basis of observations of their consultations. RESULTS: According to the findings of this study, both the GPs and the patients expected GPs to demonstrate in interaction with the patients their intent to evaluate and possibly resolve the patient’s health problem. The GPs were also expected to show that they recognized the patient’s health problem. Both GPs and patients felt that this would help to develop patients’ trust in their GPs. Smoking cessation advice during consultations could negate these demonstrations of GPs intents. Smoking cessation advice, however, could demonstrate interest and a desire to help and so develop trust.
CONCLUSION: Smoking cessation advice has the potential both to put trust under strain and to strengthen trust. The outcome depends on whether the advice conforms to what both patients and GPs expect from the interaction in general practice consultations. PRACTICE IMPLICATIONS: To develop and maintain patients’ trust GPs should consider the specific expectations from the interaction with patients during consultations when giving smoking cessation advice.
Guassora AD, Gannik D.Patient Educ Couns. 2010 Jan;78(1):46-52. Epub 2009 Jun 7.
方法：本试验包括6名丹麦全科医生与11名患者关于医学咨询观察结果而进行的访谈。
结果：结果显示，全科医生和患者都希望全科医生能与患者产生互动，评价及解决患者的健康问题。同时患者还希望全科医生能向患者显示其已了解患者的健康问题。全科医生和患者都感觉这样有助于培养患者对医生的信任。咨询时提供的戒烟建议能显示出医生渴望为患者提供帮助，从而使患者对全科医生产生信任。
结论：戒烟建议有助于培养及强化患者信任。戒烟效果有赖于建议是否符合患者和全科医生在医疗咨询互动过程中的期望。
应用价值：在给予戒烟建议时，为培养和维持患者的信任，全科医生应考虑患者与医生互动交流时的具体期望。
（刘国梁 审校）
Patient Educ Couns. 2010 Jan;78(1):46-52. Epub 2009 Jun 7.
Developing and maintaining patients’ trust during general practice consultations: the case of smoking cessation advice.
Guassora AD, Gannik D.
The Research Unit and Department of General Practice, University of Copenhagen, Denmark.
OBJECTIVE: The aim of this paper is to describe how the process of developing and maintaining trust is related to how and if smoking cessation advice is given in general practice consultations.
METHODS: The study consisted of interviews with six Danish GPs and with 11 of their patients, on the basis of observations of their consultations. RESULTS: According to the findings of this study, both the GPs and the patients expected GPs to demonstrate in interaction with the patients their intent to evaluate and possibly resolve the patient’s health problem. The GPs were also expected to show that they recognized the patient’s health problem. Both GPs and patients felt that this would help to develop patients’ trust in their GPs. Smoking cessation advice during consultations could negate these demonstrations of GPs intents. Smoking cessation advice, however, could demonstrate interest and a desire to help and so develop trust.
CONCLUSION: Smoking cessation advice has the potential both to put trust under strain and to strengthen trust. The outcome depends on whether the advice conforms to what both patients and GPs expect from the interaction in general practice consultations. PRACTICE IMPLICATIONS: To develop and maintain patients’ trust GPs should consider the specific expectations from the interaction with patients during consultations when giving smoking cessation advice.
Guassora AD, Gannik D.Patient Educ Couns. 2010 Jan;78(1):46-52. Epub 2009 Jun 7.
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