提高规范化培训住院医师在CCU沟通能力的探讨

摘要：随着生物医学模式向生物．心理．社会医学模式的转变，构建和谐的医患关系成为当今医学发展和进步的时代新要求，构建和谐的医患关系，有效的医患沟通是获得良好医疗效果的基本保证，本文总结了目前参加规范化培训的住院医师在心脏科重症监护室培训轮转期间医患沟通中存在的问题，分析了沟通障碍的主要影响因素，包括住院医师对医患关系的沟通认识不够充分，沟通技巧不够，工作负担增加，患方经济负担增加，治疗效果心理预期增加，医患双方认知差异增加，失信增加，健康和维权意识增加等都影响了医患关系的和谐构建；心脏重症监护室是心血管系统中常见病，多发病发展到终末期或急重期间的治疗场所，特点是病情急，危，重，死亡率高，结合其医患关系的实际特点，提出了提高住院医师沟通能力的可行性措施，主要包括：沟通的内容务必真实可信，形式力求形象，换位思考，注重诚信待人，加强非语言沟通，注重沟通分寸，尊重患者或家属的知情同意权，加强心脏监护室的细节规范化管理等。

Investigation of Improving the Communication Ability of Standardized Training Resident Physicians in Cardiology Intensive Care Unit

With the transition from the biomedical model to the bio - psycho - social medical model, building a harmonious relationship between doctors and patients is today＇s medical new requirements of development and progress of society, and effective phy- sician-patient communication is the basic guarantee to get good medical results. This paper summarizes doctor-patient communication problems of the residents who participate the standardization of training in the cardiology intensive care unit, and also analyzes the main factors of communication barriers, including inadequateunderstanding of the doctor-patient relationship, lack of communication skills, increased workload, increased the economic burden and the risk of side psychological expectations of the treatment effect, cognitive differences between doctors and patients, broken promises and increased health and fights awareness, which all affect the construction of harmony of the doctor-patient relationship. Cardiac intensive care unit is where treating diseases of cardiovascular system, including frequently-occurring disease developing to end-stage or during acute and severe attack which are characterized by acute, dangerous, and have high mortality; combining with the actual characteristics of physician-patient relationship in the cardiology intensive care unit, feasible methods to improve the communication skills of the residency are proposed. The methods are authentic communication in the form of empathy, focusing on the integrity of others, strengthening the non-verbal communication, focusing on communication propriety, respect for patients or their families informed consent rights, and strengthening the details of the cardiac care unit standardized management.