| Background:In recent years,the incidence and death rate of cancer in the world have increased rapidly,and cancer has become a serious threat to the health of our people.The high mortality makes the patients and their families bear a huge psychological burden and the suicide rate of cancer patients is much higher than that of other patients.Good doctor-patient communication can make patients maintain a better psychological state,reduce the psychological pain of patients,reduce the occurrence of suicidal self-injury behavior,and avoid doctor-patient disputes.There are few studies on doctor-patient communication models in China,and the doctor-patient communication models introduced from abroad have higher requirements on communication time,details and doctors’ skills.Due to the different medical environment,the daily outpatient visits of domestic outpatient doctors reach dozens or even hundreds,and there is a shortage of doctor-patient communication time.In addition,heavy clinical work,lack of communication skills of medical staff and lack of communication guidance tools for patients’ needs lead to poor doctor-patient communication efficiency and affect patients’ medical experience.It is urgent to construct a communication mode that focuses on the communication needs of cancer patients,guides doctors in communication skills,improves the effectiveness of doctor-patient communication,improves patients’ medical experience,and reduces doctor-patient disputes.Objective:This research attempts to review the doctor-patient communication related literature at home and abroad,combining both doctors interviewed for the expectation of doctor-patient communication,analyze present situation of doctor-patient communication and cancer patients demand gap between doctor-patient communication,build a simple and feasible,two-way interactive communication mode,expect to improve the effectiveness of cancer patients doctor-patient communication,treatment adherence,medical experience and medical staff communication skills to provide the reference,for clinical provides a new Angle for the research of doctor-patient communication and thinking.Methods:1.Literature analysis was adopted to search domestic and foreign databases under the guidance of humanism theory,and literature related to communication needs of cancer patients and doctor-patient communication was reviewed in accordance with retrieval strategies.2.Qualitative research method is adopted to interview doctors,nurses and patients’ expectations and demands for doctor-patient communication.Relying on the Pareto Law,the core problem of the gap between the current situation of clinical doctor-patient communication and needs is grasped,and the indicator system of doctor-patient communication mode based on the perspective of cancer patients is determined.3.The Delphi method was adopted to revise and preliminary evaluate the content of indicators,conduct reliability and validity test,and complete the construction of ESER doctor-patient communication mode based on the perspective of cancer patients.Results:1.Through literature analysis,the humanism theory is determined as the theoretical basis,and the "people-oriented" core forms the theoretical framework;By analyzing the qualitative research data and relying on the Pareto Law,the index framework of ESER doctor-patient communication model was formulated with Esteem,Specialty,Engagement and Reliance as the key first-level indicators,8 second-level indicators and47 third-level indicators.2.A total of 15 experts participated in the Delphi method,among which 11(73.3%) had the title of associate senior or above,and 4(26.7%)had the title of intermediate;11students have master degree or above(73.3%),4 students have bachelor degree(26.7%);Nine(60%)of the specialists worked in nursing management or medical education and six(40%)in clinical medicine or nursing;The average length of service of the specialists was(22.7±8.9)years.After two rounds of expert letter consultation,the final ESER doctor-patient communication mode was established,including 4 first-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 was0.85 in the first round and 0.91 in the second round,indicating a high degree of overall authority.Coefficient of variation(CV)are less than 0.25,at the same time the Kendall’s W coefficient for significant chi-square test,P values were less than 0.05,statistically significant,but experts think the coordinating degree is higher;Cronbach’sαcoefficient was 0.952 in the first round and 0.971 in the second round,indicating that the index framework had good reliability and validity.Conclusion:Based on the research purpose,this study,guided by humanistic theory and relying on Pareto’s law,reviewed literature and interviewed doctors,nurses and patients,initially formed the framework of ESER doctor-patient communication model.After screening and evaluating the indicators by Delphi method,the constructed ESER doctor-patient communication model based on the perspective of cancer patients is reasonable and scientific.The experts selected for the expert letter consultation all have high professional level,can skillfully use the research method,and have good reliability and validity after testing,so the final results obtained are reliable.As a two-way interactive communication mode,this mode integrates medicine and humanities,and can be used as a guiding tool for medical staff to communicate with cancer patients,so as to achieve mutual trust and win-win cooperation between doctors and patients.It has practical significance and can provide reference for the application and research of doctor-patient communication for cancer patients in clinical practice.However,the empirical application was only carried out in a small number of patients in the department of oncology,which has certain limitations.In the future,the sample size should be expanded based on clinical scenarios to further test the practicality. |
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