Evidence-based Analysis of Reviews on Physician-patient Communication_Chinese Journal of Evidence-Based Medicine

Authors：

WEI Maoling ¹ , SU Wei ² , LI Youping ¹ , KANG Deying ¹ , SONG Ruliang ³ , ZHANG Mingming ¹

1. Chinese Evidence-based Medicine/Cochrane Center, West China Hospital of Sichuan University, Chengdu 610041, China;2. West China Public Health College of Sichuan University, Chengdu 610041, China;3. Committee of Law in Medicine of Lawyers’ Association in Guangdong Province, Guangzhou 510053, China;

Corresponding author：

Keywords：

Physician-patient communication; Physician-patient relation; Evidence-based medicine; Systematic review

DOI：

10.7507/1672-2531.20080240

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To seek the best evidence on communication between physicians and patients so as to improve the physician-patient relationship in China.
Methods 　We used the key words ‘physician-patient relationship’ and ‘communication’ to identify related systematic reviews and meta-analyses, and then evaluated them with the Overview Quality Assessment Questionnaire (OQAQ) checklist.
Results 　Seventeen studies were included for final evaluation. According to the OQAQ checklist, the score range of the study quality was 3 to 9. 41.29% (7/17) of the included studies scored 7 to 9, 23.5% (4/17) scored 6, and 35.3% (6/17) scored 3 to 5. Factors influencing physician-patient communication primarily included communication targets, time, contents, and approaches.
Conclusion 　 There are not enough studies on physician-patient communication in China. We need to identify the problems affecting communication behavior, encourage patients to express their preferences, choose appropriate training strategies, and make timely evaluation so as to better satisfy the needs of patients and physicians.

Citation： WEI Maoling,SU Wei,LI Youping,KANG Deying,SONG Ruliang,ZHANG Mingming. Evidence-based Analysis of Reviews on Physician-patient Communication. Chinese Journal of Evidence-Based Medicine, 2008, 08(12): 1100-1104. doi: 10.7507/1672-2531.20080240 Copy

1.	江波, 刘景双. 主编. 医患关系新论. 大连理工大学出版社. 1998年 3月.
2.	张鹭鹭, 李静, 徐祖铭. 主编. 高级医院管理学. 上海: 第二军医大学出版社, 2003.
3.	邱仁宗. 临床医师面临的若干伦理问题, 中国医院, 2003, 7(4): 18-21.
4.	王玉华, 刘刚, 吴锦萍, 等. 云南省医疗纠纷调查分析. 医学与社会, 2007, 20(9): 33-35.
5.	中国医师协会. 在全国部分省市调查“医闹”的分析报告. 中国卫生产业, 2007, (2): 57-59.
6.	中华医院管理学会维权与自律工作委员会, 中华医院管理学会维权工作部.《医疗事故处理条例》实施后医疗纠纷的调查分析. 中国医院, 2004, 8(3): 8.
7.	滕朝宇, 张德茗. 湘雅二医院医患沟通研究. 中国优秀硕士学位论文全文数据库, 2006.
8.	Greene MG, Adelman RD, Friedmann E, et al. Older patient satisfaction with communication during an initial medical encounter. Soc Sci Med, 1994, 8(9): 1279-1288.
9.	Rao M. Fogarty P. What did the doctor say? J Obstet Gynaecol (Lahore), 2007, 27(5): 479-480.
10.	Murden RA, Way DP, Hudson A, et al. Professionalism deficiencies in a first-quarter doctor-patient relationship course predict poor clinical performance in medical school. Acad Med, 2004, 79(10 Suppl): S46-48.
11.	Fallowfield L, Jenkins V, Farewell V, et al. Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet, 2002, 359(9307): 650-656.
12.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008]. The Cochrane Collaboration, 2008. Available from www.cochranehandbook. org.
13.	Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol, 1991, 44(11): 1271-1278.
14.	Bosch-Capblanch X, Abba K, Prictor M, et al. Contracts between patients and healthcare practitioners for improving patients’ adherence to treatment, prevention and health promotion activities. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004808. DOI: 10.1002/14651858.CD004808.pub3.
15.	McKinstry B, Ashcroft RE, Freeman GK, et al. Interventions for improving patients’ trust in doctors and groups of doctors. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004134. DOI: 10.1002/14651858.CD004134.pub2.
16.	Lewin SA, Skea ZC, Entwistle V, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD003267. DOI: 10.1002/14651858.CD003267.
17.	R Urquhart CC, Wainwright P, Lewis R. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2000, Issue 2. Art. No.: CD002098. DOI: 10.1002/14651858.CD002098.
18.	Kinnersley P, Edwards A, Hood K, et al. Interventions before consultations for helping patients address their information needs. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD004565. DOI: 10.1002/14651858.CD004565.pub2.
19.	Rao JK, Anderson LA, Inui TS, et al. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care, 2007, 45(4): 340-349.
20.	Griffin SJ, Kinmonth AL, Veltman MW, et al. Effect on healthrelated outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med, 2004, 2(6): 595-608.
21.	Krishna SB, Spencer DC, Griffin J Z, et al. Clinical trials of interactive computerized patient education: implications for family practice. J Fam Pract, 1997, 45(1): 25-33.
22.	Ashenden R, Silagy C, Weller D. A systematic review of the effectiveness of promoting lifestyle change in general practice. Fam Pract, 1997, 14(2): 160-176.
23.	Wilson A, Childs S. The relationship between consultation length, process and outcomes in general practice: a systematic review. Br J Gen Pract, 2002, 52(485): 1012-1020.
24.	Espallargues M, Valderas JM, Alonso J. Provision of feedback on perceived health status to health care professionals: a systematic review of its impact. Med Care, 2000, 38(2): 175-186.
25.	Moxey A, O’Connell D, McGettigan P, et al. Describing treatment effects to patients. J Gen Intern Med, 2003, 18(11): 948-959.
26.	Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev, 2005, 62(3): 255-99.
27.	Harrington J, Noble LM, Newman SP. Improving patients’ communication with doctors: a systematic review of intervention studies. Patient Educ Couns, 2004, 52(1): 7-16.
28.	Petrella RJ, Lattanzio CN. Does counseling help patients get active? Systematic review of the literature. Can Fam Physician, 2002, 48: 72-80.
29.	Di Blasi Z, Harkness E, Ernst E, et al. Influence of context effects on health outcomes: a systematic review. Lancet, 2001, 357(9258): 757-762.
30.	Sullivan F, Mitchell E. Has general practitioner computing made a difference to patient care? A systematic review of published reports. BMJ, 1995, 311(7009): 848-852.
31.	Roter DL, Larson S, Shinitzky H, et al. Use of an innovative video feedback technique to enhance communication skills training. Med Educ, 2005, 39(6): 645.
32.	Merckaert I, Libert Y, Razavi D. Communication skills training in cancer care: where are we and where are we going? Curr Opin Oncol, 2005,17(4): 319-330.
33.	Oskay-O¨ zcelik G, Lehmacher DW, Ko¨ nsgen H, et al. Breast cancer patients’expectations in respect of the physician–patient relationship and treatment management results of a survey of 617 patients. Ann Oncol, 2007, 18: 479-484.

1. 江波, 刘景双. 主编. 医患关系新论. 大连理工大学出版社. 1998年 3月.
2. 张鹭鹭, 李静, 徐祖铭. 主编. 高级医院管理学. 上海: 第二军医大学出版社, 2003.
3. 邱仁宗. 临床医师面临的若干伦理问题, 中国医院, 2003, 7(4): 18-21.
4. 王玉华, 刘刚, 吴锦萍, 等. 云南省医疗纠纷调查分析. 医学与社会, 2007, 20(9): 33-35.
5. 中国医师协会. 在全国部分省市调查“医闹”的分析报告. 中国卫生产业, 2007, (2): 57-59.
6. 中华医院管理学会维权与自律工作委员会, 中华医院管理学会维权工作部.《医疗事故处理条例》实施后医疗纠纷的调查分析. 中国医院, 2004, 8(3): 8.
7. 滕朝宇, 张德茗. 湘雅二医院医患沟通研究. 中国优秀硕士学位论文全文数据库, 2006.
8. Greene MG, Adelman RD, Friedmann E, et al. Older patient satisfaction with communication during an initial medical encounter. Soc Sci Med, 1994, 8(9): 1279-1288.
9. Rao M. Fogarty P. What did the doctor say? J Obstet Gynaecol (Lahore), 2007, 27(5): 479-480.
10. Murden RA, Way DP, Hudson A, et al. Professionalism deficiencies in a first-quarter doctor-patient relationship course predict poor clinical performance in medical school. Acad Med, 2004, 79(10 Suppl): S46-48.
11. Fallowfield L, Jenkins V, Farewell V, et al. Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet, 2002, 359(9307): 650-656.
12. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008]. The Cochrane Collaboration, 2008. Available from www.cochranehandbook. org.
13. Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol, 1991, 44(11): 1271-1278.
14. Bosch-Capblanch X, Abba K, Prictor M, et al. Contracts between patients and healthcare practitioners for improving patients’ adherence to treatment, prevention and health promotion activities. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004808. DOI: 10.1002/14651858.CD004808.pub3.
15. McKinstry B, Ashcroft RE, Freeman GK, et al. Interventions for improving patients’ trust in doctors and groups of doctors. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004134. DOI: 10.1002/14651858.CD004134.pub2.
16. Lewin SA, Skea ZC, Entwistle V, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD003267. DOI: 10.1002/14651858.CD003267.
17. R Urquhart CC, Wainwright P, Lewis R. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2000, Issue 2. Art. No.: CD002098. DOI: 10.1002/14651858.CD002098.
18. Kinnersley P, Edwards A, Hood K, et al. Interventions before consultations for helping patients address their information needs. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD004565. DOI: 10.1002/14651858.CD004565.pub2.
19. Rao JK, Anderson LA, Inui TS, et al. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care, 2007, 45(4): 340-349.
20. Griffin SJ, Kinmonth AL, Veltman MW, et al. Effect on healthrelated outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med, 2004, 2(6): 595-608.
21. Krishna SB, Spencer DC, Griffin J Z, et al. Clinical trials of interactive computerized patient education: implications for family practice. J Fam Pract, 1997, 45(1): 25-33.
22. Ashenden R, Silagy C, Weller D. A systematic review of the effectiveness of promoting lifestyle change in general practice. Fam Pract, 1997, 14(2): 160-176.
23. Wilson A, Childs S. The relationship between consultation length, process and outcomes in general practice: a systematic review. Br J Gen Pract, 2002, 52(485): 1012-1020.
24. Espallargues M, Valderas JM, Alonso J. Provision of feedback on perceived health status to health care professionals: a systematic review of its impact. Med Care, 2000, 38(2): 175-186.
25. Moxey A, O’Connell D, McGettigan P, et al. Describing treatment effects to patients. J Gen Intern Med, 2003, 18(11): 948-959.
26. Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev, 2005, 62(3): 255-99.
27. Harrington J, Noble LM, Newman SP. Improving patients’ communication with doctors: a systematic review of intervention studies. Patient Educ Couns, 2004, 52(1): 7-16.
28. Petrella RJ, Lattanzio CN. Does counseling help patients get active? Systematic review of the literature. Can Fam Physician, 2002, 48: 72-80.
29. Di Blasi Z, Harkness E, Ernst E, et al. Influence of context effects on health outcomes: a systematic review. Lancet, 2001, 357(9258): 757-762.
30. Sullivan F, Mitchell E. Has general practitioner computing made a difference to patient care? A systematic review of published reports. BMJ, 1995, 311(7009): 848-852.
31. Roter DL, Larson S, Shinitzky H, et al. Use of an innovative video feedback technique to enhance communication skills training. Med Educ, 2005, 39(6): 645.
32. Merckaert I, Libert Y, Razavi D. Communication skills training in cancer care: where are we and where are we going? Curr Opin Oncol, 2005,17(4): 319-330.
33. Oskay-O¨ zcelik G, Lehmacher DW, Ko¨ nsgen H, et al. Breast cancer patients’expectations in respect of the physician–patient relationship and treatment management results of a survey of 617 patients. Ann Oncol, 2007, 18: 479-484.

Chinese Journal of Evidence-Based Medicine

Evidence-based Analysis of Reviews on Physician-patient Communication

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content