دانلود رایگان مقاله انگلیسی ارتباط با بیماران و مدت زمان مشاوره پزشکی خانواده - الزویر 2017

Abstract

Objective: To determine the distribution of consultation times, the factors that determine their length, and their relationship with a more participative, patient-centred consulting style. Design: Cross-sectional multicentre study. Location: Primary Healthcare Centres in Andalusia, Spain. Participants: A total of 119 tutors and family medicine physician residents. Principal measurements: Consultation length and communication with the patient were analysed using the CICCAA scale (Connect, Identify, Understand, Consent, Help) during 436 interviews in Primary Care. Results: The mean duration of consultations was 8.8 min (sd: 3.6). The consultation tended to be longer when the physician had a patient-centred approach (10.37 ± 4.19 min vs 7.54 ± 2.98 min; p = 0.001), and when there was joint decision-making (9.79 ± 3.96 min vs 7.73 ± 3.42 min: p = 0.001). In the multivariable model, longer consultations were associated with obtaining higher scores on the CICAA scale, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and a smaller number of daily visits (r2 = 0.32). There was no correlation between physician or patient gender, or problem type.

Conclusion

Better communication (a higher CICAA score), a patientcentred physician and shared decision-making is associated with increased consultation length. There is also a proven correlation between multivariate analysis and the number of reasons for the consultation, whether the patient is accompanied, the urban health centre and a smaller workload.