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Objective To explore the effect of health education based on interactive 3D-modeling of intracranial artery on interventional diagnosis and treatment for patients with intracranial artery stenosis.Methods A total of 70 patients requiring interventional diagnosis and treatment due to intracranial artery stenosis admitted to our department in 2022 were enrolled,and randomly divided into observation group and control group,with 35 cases in each group.Their stenotic sites of intracranial arteries included the vertebral and middle cerebral arteries.The observation group received the preoperative conventional education mode combined with interactive 3D-modeling to carry out health education,while the control group got the unified education sheet and slides to carry out routine preoperative health education.A self-made publicity and education effectiveness rating scale was used to score before and after the publicity and education,and their scores of awareness of intracranial artery stenosis,awareness of treatment plans,and satisfaction with medical treatment were compared between the 2 groups.Results Before the health education,there was no statistical differences in their awareness scores concerning intracranial vessels(normal intracranial arteries,intracranial arterial occlusion,and vascular stenosis treatment)between the 2 groups patients.After the implementation of education,the awareness scores of intracranial vessels were elevated in both groups,but the awareness scores of the normal intracranial artery,intracranial artery occlusion,vascular stenosis treatment,and treatment satisfaction were significantly higher in the observation group than the control group(P＜0.05).Moreover,the patients with middle cerebral artery and vertebral artery stenosis from the observation group obtained obviously higher propaganda score than those from the control group(P＜0.05).Conclusion The health education model combined with 3D-modeling can improve the patient's awareness of the diagnosis and treatment of intracranial artery stenosis,promote their satisfaction of medical treatment,and thus increase their compliance and the rate of interventional diagnosis and treatment,and then finally,prevent strokes caused by intracranial artery stenosis.
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The language expression level of doctors directly affects the effectiveness of information transmission and communication. In the past 20 years， a large number of studies have conducted questionnaire surveys related to “doctor-patient communication” among medical staff and patients in the form of scales， but there were few studies on the practical application of doctor-patient communication and case analysis of doctor-patient disputes. Using the Complaint Register Book of a tertiary A hospital as research material， this paper summarized five causes of medical disputes caused by medical remarks， namely， stiff tone and improper body language of the medical staff， unclear communication of treatment plans， unable to answer patients’ questions， different doctors’ statements are contrary each other， and a large gap between disease prediction and disease development. This paper aimed to analyze the handling points of such disputes， with a view to applying them in doctor-patient communication courses for medical students or language skills training for doctors in the future， optimizing doctor-patient communication， and promoting the development of doctor-patient relationships.
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By integrating the concept of narrative medicine and relevant models and tools into the Doctor-patient Communication course， this paper expounds the connotation of narrative medicine under the context of “new medicine” and “big health” and the practical significance of the shift to narrative in Doctor-patient Communication course in three aspects： academic frontier， social needs and practical needs. This paper analyzes the four dimensions of innovation that narrative medicine， as the frontier of the discipline， historical accumulation， educational philosophy and professional skills， provides for the Doctor-patient Communication course， and explores the effective path to realize the narrative transformation of the course. It is expected to achieve the purpose of forging students’ humanistic medical skills and literacy through teaching innovation， realizing the coordination of medical education and competency orientation， adapting to the psychological and social increase， the change of people and health， and promoting the reform of the supply side of medical talents.
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ObjectiveTo investigate the current status of cognition and attitude towards hospice care among medical staff in Liaocheng，analyze the related influencing factors，and to provide reference for further development of hospice care services. MethodsUsing the method of convenient sampling，404 medical staff from all levels of hospitals in Liaocheng were selected as the research subjects from January to June 2022 to conduct a questionnaire survey on the cognition and attitude towards hospice care.Statistical methods were used to analyze the related influencing factors. ResultsThe knowledge score of hospice care among medical staff in Liaocheng was （13.02 ± 4.10），with an average score rate of 65.10%.The score of attitude was （38.67 ± 5.64），with an average score rate of 64.50%.Age （41~50 years old），having received education and training，treated or cared for patients in the middle and late stages，and understanding ethics and morality，as well as cultural customs were significantly positively correlated with knowledge scores.Age （> 50 years old），professional title （deputy senior professional title），position （medical treatment），and experience in treating or caring for patients in the middle and late stages were positively related to attitude scores. ConclusionThe cognition and attitude towards hospice care among medical staff in Liaocheng were at a moderate level.Strengthening the construction of a standardized hospice care system is helpful to improve the cognition and attitude level towards hospice care among medical staff.
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By reviewing the research context of narrative medicine in China in the past five years and sorting out the development status of narrative medicine in clinical practice in China, this paper pointed out the reasons why narrative medicine is difficult to implement in clinical practice in China at present. It mainly includes three points: the awareness of narrative medicine within the clinical medical community is not high; the humanities community focuses on the development of narrative medicine in medical education, resulting in rather scarce research on narrative medicine based on clinical practice; the research objects of narrative medicine are too narrow, ignoring the importance of the public and the front-line clinical personnel in the clinical practice of narrative medicine. Accordingly, this paper proposed corresponding countermeasures: it is advocated to investigate the awareness of narrative medicine in clinical medicine and the public, and it is suggested to list them as important objects of narrative medicine education. At the same time, it is recommended that the relationship between narrative medicine and doctor-patient communication should be clarified theoretically to guide the construction of a harmonious doctor-patient relationship in clinical practice.
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Objective sampling method was used to conduct a questionnaire survey on outpatients in two hospitals in Guangdong province in order to evaluate patients’ satisfaction with the quality of medical service. This paper explored the factors that affect patients’ evaluation of medical service quality, and found that patients’ age was negatively correlated with the evaluation of medical service quality. It is suggested that the establishment of friendly medical institutions should be carried out according to the national policy. At the same time, the management mechanism of hospital should be improved, the number of medical service centers for "efficient" should be increased, and the medical service personnel should be regularly trained; carry out medical knowledge education in community, improve the popularization of personal medical knowledge and close the cognitive gap between doctors and patients.
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The aim is to evaluate the effect of therapeutic communication on cervical cancer patients’ preoperative anxiety and hope level. The convenience sampling method was used to select the inpatients who will receive radical surgery for cervical cancer in the department of obstetrics and gynecology of the Second Affiliated Hospital of Xi’an Jiaotong University from November 2016 to November 2019 as the research object. 50 patients were grouped by the random number table method: 25 patients were in the intervention group, and 25 patients were in the control group. Patients in the intervention group were given therapeutic communication on the basis of routine nursing, and patients in the control group were given routine nursing. Both groups were investigated with the Self-Rating Anxiety Scale (SAS) and Herth Hope Index (HHI) on the first day of admission and the day before surgery. Before the intervention, there was no statistically significant difference between the two groups (P>0.05) . After the intervention, the anxiety level of the intervention group was lower than that of the control group (P<0.05), and the hope level was higher than that of the control group (P<0.05). It can be seen that therapeutic communication can alleviate preoperative anxiety of cervical cancer patients, improve their hope level, promote patient recovery, and ease tense medical relationship.
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In order to understand the experience and to sort out hot spots and frontier problems of doctor-patient communication research in China. CiteSpace(5.8.R2) software was used for visualized analysis of 2 130 doctor-patient communication related Chinese literatures collected from CNKI database. The research framework and study quality and efficiency were evaluated by subject clustering analysis. The results reflected the characteristics of obvious practice forerunner, prominent academic consciousness, rich exploration achievements, more learning and reference. There were also shortcomings such as theoretical sublimation, innovative thinking, regional crossover, local experience and other aspects. Therefore, the research field should be expanded to media-based information and emotional connection, the research method should be expanded to the combination of big data mining and individual analysis-evaluation, the subject should be expanded to the depth cooperation of experts from multiple disciplines, and the research scope should be expanded to the whole process of multiple disciplines and fields.
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To construct a simple and two-way interactive doctor-patient communication mode, in order to provide guidance tools for doctor-patient communication, improve the effectiveness of doctor-patient communication for cancer patients, optimize medical experience, reduce doctor-patient disputes, and provide new perspectives and ideas for the study of doctor-patient communication. Literature review and qualitative research were used to construct the index framework of ESER doctor-patient communication model, and Delphi method was used to revise and improve the index content, and evaluate its reliability and validity. The results showed that after two rounds of expert letter consultation, the final ESER doctor-patient communication mode was established, including 4 primary-level indicators, 8 second-level indicators and 40 third-level indicators. The positive coefficient of experts was 100% in both rounds. The authority coefficient of experts was 0.85 in the first round and 0.91 in the second round, indicated a high degree of overall authority. Coefficient of variation (CV) were less than 0.25, and the Kendall’s W coefficient for significant χ2 test, P values were less than 0.05, which was statistically significant. It can be considered that the coordination degree of experts was high; Cronbach’s α coefficients in the first and second rounds of importance evaluation were 0.952 and 0.971, respectively, which indicated that the index framework had good reliability and validity. Based on the needs of cancer patients for doctor-patient communication, build a two-way interactive ESER doctor-patient communication mode, integrate medicine and humanities, which can be used as a guiding tool for medical staff to communicate with cancer patients, so as to enable doctors and patients to achieve mutual trust, cooperation and win-win results.
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By introducing the connotation of deductive teaching and analyzing the significance of early contact clinical course of "doctor-patient communication", the author reinterpreted the educational concept of deductive teaching combined with the characteristics of medical humanities, and reformed the early contact clinical course of "doctor-patient communication" by introducing deductive teaching method. Taking the early contact clinical course of "doctor-patient communication" of a medical university as an example, the teaching framework was designed to share experience from three aspects: teaching content, teaching process and teaching effect evaluation. At the same time, combined with the characteristics of the course and the needs of students, found out the problems encountered in the teaching process, and put forward constructive opinions and strategies, in order to provide theoretical and practical reference for the teaching of medical humanities course.
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The communication between professional health caregivers, which mainly composed of medical staff, and patients and their families plays an important role in hospice care. The effective doctor-patient communication can guide terminal patients and their families to establish a correct medical view, reduce excessive medical treatment, and improve the quality of life for terminal patients. This paper briefly described the communication context of hospice care, the communication subject and the current situation of hospice care, analyzed the problems and challenges encountered by professional health caregivers, which mainly including medical staff, in the communication context of hospice care diagnosis and hospice care, and made the prospects of the development of effective communication measures.
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ObjectiveTo explore the potential influencing factors and complex pathways affecting rehabilitation effect for children with autism spectrum disorder (ASD) from the perspective of parental efficacy in doctor-patient communication, and to provide evidence for improving the quality of rehabilitation service for children with ASD. MethodsAn anonymous face-to-face questionnaire survey was conducted to collect general demographic information of parents of children with ASD at designated rehabilitation institutions in Gansu province. The data included parental efficacy in doctor-patient communication, parental compliance of treatment and children's rehabilitation outcomes were collected. A structural equation model was used to explore the impact mechanism of parental communication efficacy on the rehabilitation outcomes of children with ASD. ResultsData from 519 parents at 37 rehabilitation institutions across 13 cities/counties in Gansu province were collected. Significant positive correlations were found between parental efficacy in doctor-patient communication, doctor-patient relationships, parental compliance with treatment and rehabilitation outcomes for children with ASD (P < 0.05). Through structural equation model analysis, the standardized direct effect of children with ASD from parents' doctor-patient communication efficacy was 0.151 (P = 0.023). The mediating effect of doctor-patient relationship and parental compliance with treatment were 0.160 (P = 0.001) and 0.111 (P = 0.001), respectively, with a chained mediating effect of 0.035 (P = 0.001). The pathway "parental efficacy in doctor-patient communication → doctor-patient relationship → ASD child's rehabilitation outcome" accounted for the highest proportion of the total mediating effect, at 52.29%. ConclusionParental doctor-patient communication efficacy may positively impact on the rehabilitation outcomes of children with ASD directly, and indirectly through the doctor-patient relationship and parental compliance with treatment. Rehabilitation institutions should focus on fostering parental communication skills and enhancing high-quality and humanized rehabilitation services.
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OBJECTIVE@#To preliminarily explore the applicable scenarios of an intraoral camera to assist oral anatomical landmarks recognition, so as to improve the clinical diagnosis and treatment mode, cultivate the concept of caring for patients, strengthen doctor-patient communication, assist experts to teach, and improve the clinical diagnosis and efficacy rate.@*METHODS@#A new type of an intraoral camera was applied in the recognition of oral anatomy landmarks and four application scenarios were developed, namely: (1) clinical diagnosis and treatment scenarios, in which doctors used intraoral camera to conduct a comprehensive examination of patients in the mouth and take videos and photos; (2) doctor-patient communication scenarios, when the doctor told the patient about the treatment plan, the video or photo taken by the intraoral camera was displayed to the patient; (3) expert teaching scenarios, when the expert used an intraoral camera to teach in the patient's mouth, and the young doctor learned oral anatomical signs on the projection screen, with the study of theoretical lessons; (4) difficult case recording scenarios, in the process of clinical diagnosis and treatment, when encountering difficult cases, you could use intraoral camera to record and take photos for young doctors to discuss, and experts to comment and guide.@*RESULTS@#The application of intraoral camera could: (1) improve the clinical diagnosis and treatment mode and raise the clinical diagnosis and efficacy rate; (2) stimulate young doctors' interest in learning, use intraoral camera in assessments, and skillfully combine theoretical knowledge of anatomical landmarks with clinical practice, so as to improve the teaching effect; (3) cultivate, through self or mutual use, the concept of caring for patients and reinforce the importance of gentle operation; (4) strengthen doctor-patient communication. Doctors could communicate with patients more visually, so that the patients could better understand their own situation, and strengthen the patients' trust in the doctors.@*CONCLUSION@#Intraoral camera can assist oral clinical diagnosis and treatment, such as the recognition of oral anatomical landmarks. It plays a certain role in promoting the improvement of clinical diagnosis and treatment mode, stimulating learning interest, cultivating the concept of caring for patients, and enhancing doctor-patient communication.
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Humans , Physician-Patient Relations , Physicians , Communication , Mouth , LearningABSTRACT
【Objective】 To explore the clinical application effects of animated video in doctor-patient communication before surgical treatment of ureteral calculi. 【Methods】 A total of 278 cases of ureteral calculi treated in our hospital during Jan. and Dec.2021 were selected as subjects. According to the operation periods, 146 patients treated during Jan. and Jun.2021 were classified as the conventional group, who received traditional oral explanation for preoperative conversation, while 132 patients treated during Jul. and Dec.2021 were classified as the video group who watched animated video for preoperative conversation. The two groups of patients and their families were compared in terms of operation awareness, satisfaction of preoperative conversation, anxiety, preoperative ECG monitoring abnormalities, medical complaints and so on. 【Results】 The operation awareness [(93.35±2.33) vs. (89.21±2.78) points] and satisfaction of preoperative conversation [(94.27±2.33) vs. (91.36±3.68) points] of the video group were significantly higher than those of the conventional group (P<0.05). In terms of anxiety, abnormal preoperative ECG monitoring and medical complaints, the video group also had significant advantages (P<0.05). 【Conclusion】 Using animated video to assist preoperative conversation can effectively improve the awareness of patients and their families about the operation, and alleviate the anxiety and fear of patients, so that they are more cooperative. This ensures the smooth operation and reduces the occurrence of postoperative complaints.
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Objective:To investigate the association between cancer fatalism and optimistic attitudes among colorectal cancer patients, and how the above linkage is moderated by the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making.Methods:A cross-sectional survey was conducted on 64 patients diagnosed with colorectal cancer and awaiting radical colorectal cancer surgery in the Department of General Surgery of Beijing Friendship Hospital Affiliated to Capital Medical University, from January 2021 to December 2021. There were 38 males and 26 females, aged (61.2±13.0) years from 30 to 84 years. Cancer fatalism, optimism attitudes, and the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making were assessed. The patients′ cancer fatalism beliefs were measured by the " Chance" subscale of the Form C of the Multidimensional Health Locus of Control (MHLC-C), optimism attitudes were assessed by the Chinese version of the revised Life Orientation Test (CLOT-R), and the influence of patients′, family members′, and physicians′ opinions in the medical decision-making process was measured by a self-designed single factor scale. Measurement data of normal distribution were expressed as mean±standard deviation ( ± s). Measurement data of skewed distribution were expressed as M( Q1, Q3). Spearman correlation analysis and Chi-square test was used to examine the association between the main outcome variable (patients′ optimistic attitudes) and demographic and clinical characteristics. Interaction was examined by hierarchical linear regression analysis combined with simple slope tests. Results:Cancer fatalism was negatively associated with patients′ optimistic attitudes ( r=-0.35, P<0.01). Optimistic attitude of patients was significantly and negatively correlated with the influence of family members′ opinions on medical decision-making ( r=-0.25, P<0.05). There were significant positive correlations between the influence of patients′ and family members′ opinions ( r=0.50, P<0.01), family members′ and physicians′ opinions ( r=0.67, P<0.01), and physicians′ and patients′ opinions ( r=0.38, P<0.01) in medical decision making. Hierarchical linear regression analysis showed a negative association between cancer fatalism and optimism ( β=-0.32, P=0.01). This association was further moderated by the involvement of family members′ opinions ( β=-0.56, P<0.01) and the involvement of physicians′ opinions ( β=-0.36, P=0.04) in medical decision-making. Simple slope tests revealed that the negative impact of fatalistic attitudes on patients′ optimism attitudes may be potentiated when family members′ opinions have high influence on medical decision-making, while the negative impact may be buffered to some extent when physicians′ opinions have high influence on medical decision-making. Conclusions:Cancer fatalism had a negative effect on patients′ optimism. The high influence of physicians in treatment decision-making buffered the negative effect of cancer fatalism on optimism; the high influence of family members in treatment decision-making potentiated the negative effect of cancer fatalism on optimism. In the process of doctor-patient communication and shared decision-making, for patients with strong fatalistic attitudes, consideration should be given to appropriately increasing direct informational communication between physicians and patients and reducing excessive family intervention in medical decision-making, so as to enhance patients′ autonomy for treatment, promote optimism, and reduce the negative effects of cancer fatalism.
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Based on the theory of "Johari Window", this study introduced how to stimulate information content obtained in doctor-patient communication and how to apply the comprehensive geriatric assessment creatively from the four modules of open area, blind area, hidden area and unknown area in the model. It helped students to gain the trust and cooperation of patients, rapidly narrow down the blind area, hidden area and unknown area, guide patients to actively extend the open area, improve the teaching quality of doctor-patient communication in a scientific way.
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Objective:To explore the application of Miller's pyramid theory combined with Bahrain's team activities in the standardized residency training (SRT) of burn surgeons.Methods:Seventy-four residents who were on the SRT program in the Department of Burns & Wound Care in The Second Affiliated Hospital of Zhejiang University were enrolled in the study. The students were divided into control group and observation group according to the teaching methods. Thirty-seven students in the control group were provided with conventional teaching, and 37 students in the observation group were provided with training based on Miller' pyramid theory combined with Bahrain's team activities. The two groups were evaluated for teaching effectiveness and doctor-patient communication skills. SPSS22.0 was used for the chi-square test and t test. Results:The evaluation outcome of teaching effectiveness in the observation group was better than that in the control group ( t=3.01, 3.47, 3.49, 3.32, and 2.54; P=0.004, 0.001, 0.001, 0.001, and 0.013). After the training, the scores of Set Elicit Give Understand End scale in the two groups increased, with significantly higher scores achieved in the observation group than in the control group ( t=3.23, 2.99, 2.07, 3.62, 3.00, and 7.89; P=0.002, 0.004, 0.042, 0.001, 0.004, and <0.001). Conclusion:The application of Miller's pyramid theory and Bahrain's team activities in the SRT of burn surgeons can improve students' evaluation of teaching effectiveness and improve their doctor-patient communication skills.
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Objective:To develop the interpersonal emotion regulation questionnaire for healthcare workers and examine its reliability and validity.Methods:Based on the theory of social regulatory cycle (SRC), literatures review and semi-structured interview were used to form the item pool of the scale.Through expert consultation, project analysis and the exploratory factor analysis, the scale items were screened, and the interpersonal emotion regulation questionnaire for healthcare workers was initially formed.The convenient sampling method was adopted to select 619 healthcare workers from multiple hospitals in Anhui province to conduct the formal survey to test the reliability and validity of the questionnaire and confirmatory factor analysis (CFA) using the SPSS 24.0 and Mplus 8.0 software.Results:There were 18 items and four dimensions including emotion identification, motivation, regulation strategy and implementation strategy process in the interpersonal emotion regulation questionnaire for healthcare workers.The results of CFA showed that the questionnaire fitted the data with well construct validity.The correlation coefficients between each dimension and the scale were 0.830-0.932.The Cronbach’s α coefficient of the overall questionnaire was 0.962, the split-half reliability was 0.880 and the test-retest reliability was 0.786.The score of total questionnaire was significantly positively correlated with the score of emotional intelligence ( r=0.680, P<0.001) and empathic ability ( r=0.554, P<0.001), and was significantly negatively correlated with the doctor-patient relationship ( r=-0.353, P<0.001). Conclusion:The interpersonal emotion regulation questionnaire for healthcare workers has satisfactory reliability and validity, which can be used to measure the ability of interpersonal emotion regulation in healthcare workers.
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【Objective:】 To understand the development of narrative medicine in medical schools and the cognitive level of narrative medicine among medical students. 【Methods:】 Taking 2,353 medical students nationwide as the research subjects, Knowledge, Attitude/Belief, Practice (KAP) questionnaire was distributed online to conduct a survey. The survey results were analyzed from the perspectives of general knowledge, ways to understand narrative medicine, and cognitive level of parallel medical records. 【Results:】 44.50% of the survey respondents had never learned about narrative medicine, and 50.79% of them had never heard of parallel medical records. 26.80% of the survey respondents had participated in the training of narrative medicine courses, while most medical students learned about narrative medicine through other ways. 【Conclusion:】 This paper showed that the majority of the survey respondents are not familiar with the key concepts of narrative medicine. By introducing the concept of big culture in anthropology into medical college education or exploring the perspective of doctor-patient interaction, integrating communication models to improve doctor-patient relationships. The current popularization level of parallel medical records and narrative types among medical students is not good, and the cultivation of cultural sensitivity and reflective ability may help promote the teaching and application of parallel medical records. Multiple learning pathways lay the foundation for further teaching, and build a diversified teaching system to enrich the course content, which should be the focus of promoting narrative medicine education in the future.
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Doctor-patient shared decision-making is a medical decision-making model that involves mutual interaction and communication between doctors and patients. The lack of patient’s subjectivity is mainly manifested in the departure of patients’ "subject" caused by the deviation of medical purpose and the influence of traditional culture, the weak position of patients formed by the difference in the strength of social role, the obstacle of doctor-patient communication caused by the difference of disease situation perception, etc., which has become a prominent problem hindering the development of doctor-patient shared decision-making mode. Taking the mutual subjectivity of doctors and patients as the premise, effective doctor-patient communication as the basis, and doctor-patient shared decision-making as the main axis, the construction of concentric medical care under a doctor-patient community with a shared future can help build up the subjectivity and mutual relationship between doctors and patients, and provide a path for the retrieval of patient subjectivity.