Respecting and understanding patients is the key to communication between doctors and patients. Doctors should not only know the rights of patients, but also understand the language and mood of patients and their families, and tolerate and accept the personality and habits of patients. Doctors should realize that they are equal to patients, and what is more than each other is only professional knowledge and skills. In the eyes of patients, doctors' sincere understanding attitude is expressed through the most basic components of interpersonal communication such as tone, posture and expression. Only when the doctor really cares about the patient's condition and truly understands the patient's mood can his sincere attitude be revealed from his words, gestures, movements, eyes and expressions, making the patient feel comfortable and at ease. This attitude is not a skill, and there is no way to practice with practice. It exists in everyone's heart and needs to be cultivated by doctors themselves.
Medical staff must also master the methods of psychological communication with patients. Patients with different diseases have different psychological characteristics, and the same patient has different psychological characteristics at different stages of the disease. Even different medical environments can cause different psychological changes of patients. Medical staff should understand the psychological needs of patients, do psychological counseling in a targeted manner, and correctly guide the expectations of patients and their families for hospital treatment and nursing. Medical staff should listen to the voices of patients and their families patiently, which can not only relieve their emotional and psychological pressure, but also have a positive impact on the treatment itself.
After reading this article, some medical staff may say, "It's all about making doctors understand patients again. Why not let patients think for doctors?" As the article says, respect and understanding are the key to communication. Starting today, we will discuss the topic of "doctor-patient psychology, how to communicate". I hope everyone can talk about their gains and losses, experience and understanding in doctor-patient communication in combination with their actual feelings in work and medical treatment.
The last doctor a patient wants to see:
1. Before he finished, the doctor rudely interrupted the patient and even began to write a prescription.
There are several patients in the clinic at the same time, and the doctor talks to several patients at the same time.
3. After the prescription is issued, do not explain the prescription to the patient, and do not explain the precautions and how to treat it next.
4, the doctor in the patient's statement showed indifference, impatience, or talk to the patient and do other things.
At the time of initial diagnosis, doctors should listen carefully, communicate patiently and communicate well. Grasp the initiative of conversation and evaluate and locate patients as much as possible. It is very critical and complicated to ask experts to talk with patients for at least 30 minutes at the first visit. We'll discuss it later. Evaluate and locate patients from five aspects:
L, from the economic conditions: can be divided into good, medium and poor. Money is the basic condition. Willing to pay for medical treatment, money at home and money at the disposal of patients are two different concepts. Doctors must work hard and realize this.
2, from the degree of disease:
1), seeking medical treatment at the early stage of onset, paying attention to the condition, paying attention to their own health, and having a strong desire to seek medical treatment.
2), casually seek medical advice, consult patients, have a certain attention to health, and have not made up their minds to pay medical expenses.
3), seek medical advice, long illness into medicine, chronic recurrence, many complications, patients have doubts about hospitals and doctors.
3. From the basic quality and knowledge level, it can be generally divided into high quality, high quality, medium quality and poor quality. Doctors have different basic qualities and knowledge levels, so they should communicate with them in different languages and means.
4. According to the place of residence: the patient is from this city, from other places, near the hospital, etc. Patients from other places usually prepare a certain amount of money to seek medical treatment.
5. According to the patient's age: 28-48 years old is the age with high incidence of sexually transmitted diseases, and the patient's economic strength is relatively good.
Doctor-patient communication (2) Patience and meticulous indoctrination (1) Establish a good first impression: When patients come to the hospital, the guiding nurse should use a good image, polite language and proper manners to ask the patients what they are coming to the hospital for. After asking, it is very important to help patients register and lead them to the corresponding consultation room. At this time, it is very important to recommend and introduce specialists. We should make good use of the "authority expansion method" to improve the image of specialists, and establish the concept of "preconceptions" for patients with the authority of first-time doctors. When you bring a patient into the consulting room, you must say "please sit down" and "invite an expert (director) to see you". In terms of consultation process, the whole consultation process has already started from the moment the guiding nurse contacts the patient!
(2) Smile service warms people's hearts: When the patient walks into the consulting room, the doctor should take the initiative to greet the patient and ask him to sit down. The doctor's smile can relieve the patient's nervousness and relieve the patient's pressure. According to the principle of communication, it is very important to grasp the expression of the first 7 seconds in interpersonal communication and give people the best first impression. First-time patients will be very concerned about the doctor's expression, including smile and eyes. The change of face and eyes is the most abundant part of human language, and eyes are the core of facial expressions. Doctors should look at patients and show sincerity and respect when talking with them. Smile is the most infectious facial expression, which embodies the doctor's friendliness, respect, understanding and care for patients. Smiling can make doctors more attractive, make patients understand and respect themselves, and make a good start for future communication.
(3) Do a good job in medical documents: Regular private medical institutions attach great importance to the preparation of medical documents, and the medical records of specialist clinics should be carefully implemented. We must abandon the old habit of traveling doctors who only see a doctor without making a medical record, and first instruct patients to fill in the basic items on the outpatient medical record: name, gender, age, occupation, work unit, address, contact number, etc. Sometimes STD patients don't want to fill in their real names. Doctors should fully understand that they can fill in a fictional name. Some patients will ask, what is the relationship between seeing a doctor and their occupation and unit? Doctors should patiently explain that these items are not harmful to individuals, and mainly report to the national health authorities, so as to make statistical and epidemiological analysis of the affected people, formulate relevant measures, and collect data for disease prevention and treatment. If the patient still refuses to fill it out, don't force it! Contact telephone is for the convenience of patients, and doctors can also take the initiative to tell patients their telephone numbers, so that patients can have a psychological balance.
Information about patients is our wealth. Doctors can roughly judge the patient's condition according to the information on the medical record, understand his cultural quality and social level, and infer his economic situation. Prepare for the next patient evaluation and positioning.
It is very important to record the medical history, signs, laboratory results, initial diagnosis and treatment methods. Medical documents are tools to help doctors understand and analyze patients' condition. In the event of a dispute, they are legal documents and important documents. Specialist doctors must form a good and correct habit of writing medical documents.
(4) Questions that should be paid attention to when asking about medical history: Doctors are very particular about asking about medical history and deserve serious study. First ask the patient what's wrong, when it started, how to treat it, and pay special attention to the treatment in other hospitals, what medicine was used, and how effective it was. When asking about medical history, you should pay attention to the following points:
1, when listening to the patient's statement, the doctor should show concern and concern and look at the patient with a smile. If the patient is too nervous and doesn't know how to speak, encourage the patient to "don't worry, speak slowly" and "think about what's wrong".
2. Sometimes doctors have to take the patient's topic and remind or imply that the patient has certain symptoms, which can pave the way for future examination and treatment. For example, when talking about frequent urination, remind patients "Does it hurt when urinating?" "Is the urethra itchy?" "Is there any secretion overflowing from the urine mouth?" "Does the testicle hurt, is it swollen?" Wait a minute.
When the first symptom appears, it is very important to ask. First, we can know the length of the course of the disease, which is very valuable for analyzing the stages of the disease, possible complications and complications. Second, patients' worries about their own health can be analyzed. Those who come to the hospital as soon as they get sick: they are very concerned about their health, have good psychological quality and are willing to spend money on health; Those who seek medical treatment after a long illness: 1) Poor economic conditions; 2) I usually don't pay attention to my health; 3) Seek medical advice if you are too busy; 4) Lack of medical and health knowledge.
L, be sure to ask about the treatment outside the hospital: asking about the treatment in other hospitals will help doctors to further understand the patients and their mentality of seeking medical treatment, and remind doctors to avoid repeated medication and ineffective treatment. At this time, doctors should dare to deny the treatment in their own hospitals. "The method is wrong, the medication is improper, and the analysis of the condition is not thorough, so the curative effect is not good!" It is necessary to introduce the advanced treatment theory, scientific treatment plan, advanced equipment and physiotherapy methods in our hospital, and persuade patients to accept the doctor's diagnosis and treatment plan with specific cases and comparative methods.
(five) seriously, carefully and orderly to check the patients:
1, male patient examination:
1) Careful and orderly specialist examination: This is an opportunity to leave a good impression on patients, and doctors should not miss this opportunity. Some doctors don't examine their patients seriously, and even don't let them take off their pants. They just open their pants to reveal their penises, which is very wrong (especially when they come back for follow-up, such mistakes are easy to happen). Some doctors examine patients without certain examination procedures, giving them the feeling that "doctors are rough and have no clinical experience". The specialist examination must be careful, and the most taboo is to omit the examination. When the patient says something abnormal, the doctor will only find some signs after the re-examination, which is a great blow to the doctor's prestige and should be avoided as much as possible.
2) Further ask sensitive questions with strong privacy through inspection: at this time, doctors and patients are one-to-one, and the environment is conducive for doctors to ask some personal privacy questions. When the glans penis is red and swollen and there is secretion in the urine mouth, the doctor will ask, "Have you taken a sauna recently? Have you ever had sexual contact with a young lady? " Patients feel that doctors respect their privacy and are more likely to tell the truth.
3) The operation should be in place when taking samples, and the samples should be taken out for inspection in time: the urethral swab should be rotated at least three times when taking secretions. The method of extracting prostatic fluid should be correct, and the strength of finger massage should be mastered properly.
2. Examination of female patients:
The general principles of examination for female patients are the same as those for male patients. Doctors should arrange gynecological examination together with sampling as far as possible to reduce the number of times patients take off their pants and go to the examination bed. Because of different diseases, female patients take samples of vaginal secretions at different locations, such as cervical orifice, posterior fornix, vaginal wall in deep vagina and so on. Never take a sample of vulvar secretion for examination in order to save trouble.
3, check the patient attention points:
1) should be carefully checked to avoid omission.
2) The movements should be light and skilled.
3) The examination process is a process of communication with patients. Positive findings should be informed in time, and the tone of special signs should be exaggerated appropriately. Gynecology can reflect through the mirror, showing patients the degree of lesions, vaginal congestion, secretions, cervical erosion and so on, laying the foundation for future treatment and comparison.
4) Pay attention to the patient's reaction and performance when communicating. This is an important material for judging and evaluating patients.
4, check and take samples after work:
1) Make records carefully.
2) Decisively tell the patient what problems exist and what diseases may be. In order to make a definite diagnosis, laboratory examination or other instrument examination must be done first: (B-ultrasound, X-ray photography, electrocardiogram, etc.). The doctor should tell the patient why these tests should be done, how much it will cost and when the results can be obtained.
3) At this time, the patient should be arranged and informed to sit in the infusion room for a while, watch TV and relax, and then invite the patient to the consultation room after the test results come out.
The future work is to further communicate, exchange and persuade patients according to the results of laboratory tests, and to make a good prescription according to the evaluation and positioning of patients.