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To what Extent is the Role of Communication-skills Training Leading to Positive Outcomes in Primary Health Care? : A Systematic Review

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주제분류의학일반

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Abstract

본문은 서구의 1차 의료기관에서 시행된 의료소통 훈련교육이 가져오는 긍정적 효과에 대해 체계적으로 검토하였다. 검토대상이 된 연구는 모두 유럽 및 북미 문화권에서 시행되었다. 대상 다섯 연구는 모두 RCT였으나 한 연구만 의료공급자와 환자측면 모두를 통제하였다. 임상의사소통 훈련교육은 의료공자 일인당 평균 13.5시간동안 진행되었고 핵심교육내용은 능동적 듣기 훈련, 환자의 질병인식, 환자입장에서 생각하기, 비언어 요소, 환자에게 질문할 기회제공 및 감정적 문제 다루기 등의 공통점이 발견되었다. 그러나 각 교육 프로그램마다 상이점 역시 존재하며, 교육 방법 및 매체 또한 상당히 넓은 폭을 보였다. 결과는 평균적으로 약 23.9%의긍정적 효과를 가져왔으며, 교육효과는 약 6~8개월 지속되는 것으로 분석되었다. 그러나 효과측정에 있어 주관적 지표가 필연적으로 포함되는바 측정의 정확도의 문제가 될 수 있으며, 나아가 객관적이라 할 수 있는 임상지표들은 대조군과 유의한 차이점을 보여주지 못했다. 이와 같은 연구결과는 의료인에 대한 의사소통 교육에 대한 긍정적 효과를 반영하지 못하므로, 의료공급자 및 환자 양쪽 측면을 모두 통제한 장기 관찰 연구가필요할 것이다.

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