Résumé :
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[BDSP. Notice produite par INIST VR0xTQfJ. Diffusion soumise à autorisation]. Context Patients often present clues (direct or indirect comments about personal aspects of their lives or their emotions) during conversations with their physicians. These clues represent opportunities for physicians to demonstrate understanding and empathy and thus, to deepen the therapeutic alliance that is at the heart of clinical care. A paucity of information exists regarding how physicians address the psychological and social concerns of patients. Objectives To assess how patients present clues and how physicians respond to these clues in routine primary care and surgical settings. Design, Setting, and Participants Descriptive, qualitative study of 116 randomly selected routine office visits to 54 primary care physicians and 62 surgeons in communitybased practices in Oregon and Colorado, audiotaped and transcribed in 1994. Main Outcome Measures Frequency of presentation of clues by patients during office visits, nature (emotional vs social) and content of clues, and nature of physician responses to clues, coded as positive or missed opportunity. Results Fifty-two percent and 53% of the visits in primary care and surgery, respectively, included 1 or more clues. During visits with clues, the mean number of clues per visit was 2.6 in primary care and 1.9 in surgery. Patients initiated approximately 70% of clues, and physicians initiated 30%. (...)
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