乳房超声期间的沟通,超声医师对患者的鉴别诊断报告-澳大利亚的经验

P. Milne , K.M. Spuur
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引用次数: 1

摘要

随着技术的进步,超声医师的工作越来越独立,越来越专业,在乳房超声过程中形成亲密的关系,并进行更广泛的交流。然而,目前任何交流的性质和范围都是未知的。本研究旨在检查超声医师的态度、信念、恐惧和制约因素,这些因素决定了鉴别诊断的沟通。方法对有目的的超声医师进行问卷调查。其中包括与人口统计、经验和就业有关的问题。对沟通、非语言暗示、约束、沟通技巧和对披露的恐惧进行了评价。整理后,开发了描述性统计。结果82%的问卷回收率。89%的超声医师同意病人意识到非语言暗示。83%向患者传达了正常和异常的发现。32%的医生用隐晦的语言回答病人的问题。65%的人在没有限制信息交流内容和数量的情况下工作。对医疗法律问题的恐惧和对医生失去信任是决定进行鉴别诊断的重要影响因素。结论本研究展示了乳腺超声鉴别诊断的多种方法。这项研究为超声医师想要传授鉴别诊断的具体指南的发展提供了证据。还建议提供沟通技巧讲习班,以指导和提供处理“坏消息”时患者和超声医师情感需求的策略。
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Communication during breast ultrasound, the reporting of differential diagnosis to patients by sonographers – The Australian experience

Introduction

With technological advancement sonographers work with increasing independence and expertise, forming intimate relationships and engaging in extended communication during breast ultrasound. However the nature and extent of any current communication is unknown. This study set out to examine sonographer's attitudes, beliefs, fears and the constraints that determined the communication of differential diagnosis.

Method

A survey was sent to a purposive sample of sonographers. Questions relating to demographics, experience and employment were included. Comments on communication, non-verbal cues, restraints, communication skills and fears of disclosure were asked. Following collation descriptive statistics were developed.

Results

82% of the surveys were returned. 89% of sonographers agreed patients were aware of non-verbal cues. 83% communicated normal and abnormal findings to the patient. 32% reported using cryptic language to answer patient's questions. 65% worked in practices that placed no constraints on what or how much information was communicated. Fear of medico-legal issues and loss of credibility with medical practitioners rated highly as an influence in the decision to impart a differential diagnosis.

Conclusion

The study demonstrated varied approaches to the provision of differential diagnosis during breast ultrasound. This study has provided evidence for the development of specific guidelines for sonographers wanting to impart differential diagnosis. The provision of communication skills workshops to guide and provide strategies to deal with the emotional needs of the patient and sonographer when “bad news” is to be given is also recommended.

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