临床访谈:一种重要但被忽视的医学方法。

IF 16.3 1区 医学 Q1 PSYCHIATRY Psychotherapy and Psychosomatics Pub Date : 2024-01-01 Epub Date: 2024-02-21 DOI:10.1159/000536490
Giovanni A Fava, Nicoletta Sonino, David C Aron, Richard Balon, Carmen Berrocal Montiel, Jianxin Cao, John Concato, Ajandek Eory, Ralph I Horwitz, Chiara Rafanelli, Ulrich Schnyder, Hongxing Wang, Thomas N Wise, Jesse H Wright, Stephan Zipfel, Chiara Patierno
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引用次数: 0

摘要

临床问诊是了解患者感受和主诉、获取病史、评估与健康和疾病相关的个人态度和行为、向患者提供有关诊断、预后和治疗的信息,以及在患者和医生之间建立联系的基本方法,这种联系对于共同决策和自我管理至关重要。然而,这项基本技能的价值受到了时间压力和对技术重视程度的威胁。当前的医疗保健趋势将昂贵的检查和治疗程序视为特权,并将用于与患者互动的时间视为缺乏成本效益。相反,花时间询问病人的问题和生活环境,实际上可能有助于避免进一步的检查、手术和转诊。此外,病人与医生之间的对话也是提高病人参与健康行为积极性的重要手段。本文旨在概述临床问诊及其最佳使用方法,包括问诊风格、流程和假设检验、临床领域、根据环境和目标进行的修改以及教学。这篇综述指出了面谈在临床过程中的首要地位。面谈的质量决定了所收集数据的质量,并最终决定了评估和治疗的质量。因此,面谈在教育培训中应得到更多关注,在临床实践中也应得到比目前更多的空间。
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Clinical Interviewing: An Essential but Neglected Method of Medicine.

Clinical interviewing is the basic method to understand how a person feels and what are the presenting complaints, obtain medical history, evaluate personal attitudes and behavior related to health and disease, give the patient information about diagnosis, prognosis, and treatment, and establish a bond between patient and physician that is crucial for shared decision making and self-management. However, the value of this basic skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness. Instead, the time spent to inquire about problems and life setting may actually help to avoid further testing, procedures, and referrals. Moreover, the dialogue between patient and physician is an essential instrument to increase patient's motivation to engage in healthy behavior. The aim of this paper was to provide an overview of clinical interviewing and its optimal use in relation to style, flow and hypothesis testing, clinical domains, modifications according to settings and goals, and teaching. This review points to the primacy of interviewing in the clinical process. The quality of interviewing determines the quality of data that are collected and, eventually, of assessment and treatment. Thus, interviewing deserves more attention in educational training and more space in clinical encounters than it is currently receiving.

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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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