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目的探讨医患沟通培训各要素对培训效果的影响。方法收集在1993年1月1日至2009年5月31日期间发表的有关医患沟通培训随机对照研究英文文献;计算各研究培训效果的效应尺度;采用Inverse-variance-weighted oneway ANOVA方法对沟通培训方式、培训对象、研究设计方法和沟通培训内容等各要素与培训效果的关系进行单因素和多因素分析。结果纳入研究的关于医患沟通培训的总体培训效果为中等强度。在培训对象方面,对医生、护士或医护混合培训的效果差异无统计学意义(P=0.0597)。在培训方式方面,采用的培训方式越多,培训效果越好(P=0.0012),其中在培训中采用演示和反馈对提高沟通培训效果有显著作用(P<0.05)。在培训内容方面,对“医患信息交流和患者教育”和“从生物-社会-心理角度理解患者问题”沟通技能的培训对提高沟通培训效果有显著影响(p=0.0002,P<0.0001)。结论当前医患沟通培训的总体效果接近中等强度,在沟通培训各要素中,培训方式(演示和反馈)和培训内容(“医患信息交流和患者教育”和“从生物-社会-心理角度理解患者问题”)是影响培训效果的重要因素。
Objective To explore the influence of various elements of doctor-patient communication training on training effect. Methods The English literature on randomized controlled study of doctor-patient communication was collected from January 1, 1993 to May 31, 2009; the effect scale of each training effect was calculated; and the effect of communication Training methods, training objects, research and design methods and communication training content and other factors and the relationship between the training effect of single factor and multivariate analysis. Results The overall training effect on patient communication training included in the study was moderately effective. There was no significant difference in the effectiveness of training for doctors, nurses or doctors and nurses (P = 0.0597). In terms of training methods, the more training methods used, the better the training effect (P = 0.0012). The use of demonstration and feedback in training played a significant role in improving communication training effect (P <0.05). In terms of training content, training on communication skills of doctor-patient communication and patient education and understanding of patient problems from the bio-social-psychology perspective had a significant effect on improving communication training effectiveness (p = 0.0002, P <0.0001). Conclusions The current overall effectiveness of doctor-patient communication training is close to medium intensity. Among the various elements of communication training, the training methods (demonstration and feedback) and training content (“doctor-patient communication and patient education” and “ Psychological understanding of patient problems ”) is an important factor affecting the training effect.