| Titre : | Soliciting the patient's agenda : Have we improved ? (1999) |
| Auteurs : | M.K. Marvel ; H.B. BECKMAN ; R.M. EPSTEIN ; K. FLOWERS ; Primary Care Institute. Highland Hospital. Rochester. NY. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 281, n° 3, 1999) |
| Pagination : | 283-287 |
| Langues: | Anglais |
| Mots-clés : | Relation médecin malade ; Médecin généraliste ; Evaluation ; Homme ; Etats Unis ; Amérique ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST MNR0xRn1. Diffusion soumise à autorisation]. Context Previous research indicates physicians frequently choose a patient problem to explore before determining the patient's full spectrum of concerns. Objective To examine the extent to which experienced family physicians in various practice settings elicit the agenda of concerns patients bring to the office. Design A cross-sectional survey using linguistic analysis of a convenience sample of 264 patient-physician interviews. Setting and Participants Primary care offices of 29 board-certified family physicians practicing in rural Washington (n=1 ; 3%), semirural Colorado (n=20 ; 69%), and urban settings in the United States and Canada (n=8 ; 27%). Nine participants had fellowship training in communication skills and family counseling. Main Outcome Measures Patient-physician verbal interactions, including physician solicitations of patient concerns, rate of completion of patient responses, length of time for patient responses, and frequency of late-arising patient concerns. Results Physicians solicited patient concerns in 199 interviews (75.4%). Patients'initial statements of concerns were completed in 74 interviews (28.0%). Physicians redirected the patient's opening statement after a mean of 23.1 seconds. Patients allowed to complete their statement of concerns used only 6 seconds more on average than those who were redirected before completion of concerns. (...) |
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