以患者为中心的沟通和行为指导：牙科实践中培训师-医生模式的探索性评估
Patient-Centred Communication and Behavioural Guidance: An Exploratory Evaluation of the Trainer-Doctor Model in Dental Practice.
摘要(中文译文)
培训者-医生模式（Trainer-Doctor Model，TDM）是一种参与式范式，其中医生充当导师和教育者。有效的健康沟通和患者参与是治疗依从性和健康结局的关键决定因素。基于这一概念框架，本研究旨在评估牙科从业者和患者对培训者-医生模式的偏好，考察人口学变量的影响，并依据COSMIN（基于共识的健康测量工具选择标准）对TDM问卷进行初步的心理测量学评价。2023年5月至2024年4月在罗马尼亚开展了一项横断面调查。研究对象包括在牙科科学会议期间招募的牙科从业者以及从罗马尼亚阿尔巴尤利亚一家私立牙科诊所招募的患者。符合条件的参与者为年满18岁、签署书面知情同意书并完成数据保护要求的成年人。未满18岁或未提供完整知情同意书的个体被排除。参与者完成了一份包含12个条目的Likert型问卷，用于评估对培训者-医生模式的偏好。两组均表现出较高的TDM偏好（从业者：43.93 ± 5.56；患者：44.77 ± 4.84； = 0.195）；71%至76%的回答为高偏好（≥4）。纳入反向计分条目后的Cronbach's α为0.752/0.651。探索性因子分析（EFA）（KMO = 0.740；Bartlett's < 0.001）识别出三因子结构，解释了51.3%的方差。患者在条目A（ = 0.002）、B（ = 0.022）和F（ = 0.005）上的得分显著更高。两组在不同人口学特征下均表现出对TDM强烈且一致的偏好。初步心理测量学评价表明内部一致性和结构效度可接受；然而，仍需进一步验证，包括基于德尔菲法的内容验证和验证性因子分析。
Abstract
The trainer-doctor model (TDM) is a participatory paradigm in which the physician acts as a mentor and educator. Effective health communication and patient engagement are key determinants of treatment adherence and health outcomes. Based on this conceptual framework, the present study aimed to assess preferences for the Trainer-Doctor Model among dental practitioners and patients, examine the influence of demographic variables, and provide a preliminary psychometric evaluation of the TDM questionnaire in accordance with the COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) criteria. A cross-sectional survey was conducted in Romania between May 2023 and April 2024. The study included dental practitioners recruited during scientific dental conferences and patients recruited from a private dental practice in Alba Iulia, Romania. Eligible participants were adults aged 18 years or older who provided written informed consent and completed the data protection requirements. Individuals younger than 18 years of age or those who did not provide complete informed consent were excluded. Participants completed a 12-item Likert-type questionnaire assessing preferences toward the Trainer-Doctor Model. Both groups showed high TDM preference (practitioners: 43.93 ± 5.56; patients: 44.77 ± 4.84; = 0.195); 71-76% of responses were high-preference (≥4). Cronbach's α with reverse-scored items was 0.752/0.651. EFA (KMO = 0.740; Bartlett's < 0.001) identified a 3-factor structure, explaining 51.3% of the variance. Patients scored significantly higher on items A ( = 0.002), B ( = 0.022), and F ( = 0.005). Both groups demonstrate a strong, consistent preference for TDM across demographics. The preliminary psychometric evaluation indicates acceptable internal consistency and structural validity; however, further validation, including Delphi-based content validation and confirmatory factor analysis, is required.
如何引用
AMA
Lucian Josan, Elena Gabriela Strete, Alina Ormenișan, Ioana Cristina Talpos-Niculescu, Diana Marian, Andreea Salcudean, et al. Patient-Centred Communication and Behavioural Guidance: An Exploratory Evaluation of the Trainer-Doctor Model in Dental Practice.. Healthcare (Basel, Switzerland). 2026; doi:10.3390/healthcare14121759.
APA
Lucian Josan, Elena Gabriela Strete, Alina Ormenișan, Ioana Cristina Talpos-Niculescu, Diana Marian, Andreea Salcudean, et al (2026). Patient-Centred Communication and Behavioural Guidance: An Exploratory Evaluation of the Trainer-Doctor Model in Dental Practice.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare14121759
GB/T 7714
Lucian Josan, Elena Gabriela Strete, Alina Ormenișan, Ioana Cristina Talpos-Niculescu, Diana Marian, Andreea Salcudean, et al. Patient-Centred Communication and Behavioural Guidance: An Exploratory Evaluation of the Trainer-Doctor Model in Dental Practice.[J]. Healthcare (Basel, Switzerland), 2026 doi:10.3390/healthcare14121759.
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