GIAO TIEP CUA BAC SI V6l BENH NHAN Oi BENH VIEN TRUNG UONG QUAN D O I 108 NGUYEN THI DUNG " Tdm tat: Giao tiip giiia bdc si vdi bink nfidn diin kkdng gian tfiogi trUdng mang tink cdng cdng Khi gap bdc si dikhdm vd diiu tri, binh nhdn thudng biiu hiin lo ldng, sq hai, chdn ndn, suy sup Bi giup binh nfi&n nhank cfidng pkuc koi sdc kkoe trd lgi cudc sdng gia dink, xd fidi; bdc si fiki tiip xdc, gdp gd bink nkdn kg khai thdc tdi da binh sd vd khdm ldm sdng cho binh nhdn mdt cdch hiiu qud thdng qua float d^ng giao tiep bang ldi Phgm vi bdi viit ndy chung tdi ldm ro vai tr^ cua fidnk dgng ngdn td giao tiip giiJki bdc si vdi bink nhdn tgi binh vi^n Trung Ucmg Qudn ddi 108, gop pfidn n&ng cao ckit luqng khdm chda binh cho ngUiJi binh Ta khoa: Binh viin Trung Ucfng Qudn dgi 108; bdc si; binh nfi&n; giao tiip; sdc kkoe Abstract: Communication between doctors and patients usually occurs in public spaces, with patients experiencing anxiety, fear, boredom or desperation during tfie conversation For correct diagnosis and treatment, doctors need to know kow to collect information on patients' medical history and symptoms througk effective verbal communication witk patient This article clarified the role of speaking in verbal communication between doctor and patient at 108 Military Central Hospital Keywords: 108 Military Central Hospital, doctor, patient, communication, health Ngdy nhdn bdi: 03/5/2017;Ngdy sda bdi: 15/5/2017;Ngdy duyit ddng bdi: 17/6/2017 Md dau Bfnh vifn Trung fldng Qufin ddi 108 thfinh lfip nftm 1950 tiln than lfi bfnh vifn Thuy Khdu Trai qua gdn 70 nfim xfty dflng, cMe'n dfi'u vfi trfldng thanh, bfnh vifn trd thfinh dia ehi tm cfty phiie vu, ehfim sde sfle khde cho bd ddi vfi nhftn dan Hft Nfli ndi rifing, ea nflde ndi ehung D I dat Mfu qua cao khftm chfla bfnh eho bfnh nhftn, bfin canh dfii ngu y bac si "Iftnh nghi", nhiet tinh, trftch nhifra tM ylu to' quan trpng gdp phdn nftng eao ehdt Ifldng khfira chfta bfnh tai bfnh vifn ludn dvlcic lfinh dao bfnh vifn quan tftra dd 1ft vifc chd, trgng hoqt ddng giao tiip giOa bdc si vdi binh nhdn Di lara ro vai trd eua giao tilp khara vfi chfta bfnh tai bfnh vifn, chung tdi tien hfinh khao sat 50 cudc thoqi giao sti 6-2017 tiip gifta bfie si vdi bfnh nhftn d cfte khoa: Ndi tira raaeh, Ndi tifiu hda, Ndi thdn kinh, Tai raui hpng vfi Vifn Chftn thfldng Chinh hinh cua Bfinh vifin Vai tro giao t i l p gifta bfic si vdi benh nhan Giao tifi'p Ifi rafit nghf thuftt, lfi mdt nhu cau ddi sing xft hfli, diln hfing ngfiy Giao tiep ehinh lfi dflng Ifle thue day sfl Mnh thfinh vfi phftt triln eua nhftn cftch, nhd giao tilp mfi ngfldi sfi tfl Meu nunh dfldc nMlu hdn, ddng thdi thflng qua giao tifi'p hieu dflde tfim tfl tMh cam, f nghi, nhu cdu eua ngfldi khae Hieu mfit each ddn gian nhat vfi chung nhdt, giao tilp (communication) dflde Meu '"' NCS Khoa Ngfln ngQ h^c, Hoc vien Khoa hqc xa h§i; Giang vign Tnidng Dgi hoc T r i n QuSc T u & NHAH LQC KHOA HOC XA Htfl [ Q GIAO TIEP CUA B A C SI V l BfiNH NHAN la trao doi, tiip xue vdi Quft trinh nfiy diin gifla it nhdt 1ft hai ngfldi, gfin vdi mpt ngfl eanh vfi rapt tinh h u i g nhdt dinh Nhftm nftng cao chdt Ifldng khfim chfta bfnh eho bfnh nhfin, dfii ngu y bftc si benh vifin Trung fldng Qufin dpi 108 lufin chfl trpng rfin luyfin k^ nfing giao tilp Bftc si Mfin cfi' gdng tira cftch t r u y i n dat dflde n M l u hdn eai mft bftc si ndi Tai eae ed sd f tfi' t M ki thuftt khdng the thay thfi' dflde giao tifip Ngfty cd rat n M l u y l u to lfim tfing Mfiu qua efing tae dieu tri vft eham sde sfle khde ngfldi bfinh, dd 1ft: Sfl tien bd cua khoa hpe ki t h u f t nhfl vifie eft'y ghep mfit sfi' bfi phftn ed the eon ngfldi: ghfip thfn, gan, tim Id t h u f t mo npi soi rudt thfla, tui mfit, Hifu qua eua eae loai mfty mde, trang t M i t bi y te Mfin dai chdn dofin bdng h m h anh: ehup efit ldp, ehup efing hfldng tfl Dftc bift, nghf thuftt giao tilp, flng xft cua nhftn vifin y t l ndi chung vft bftc si, d i l u dfldng ndi rieng vdi ngfldi bfnh t h i Men tdm long nhftn fti, sfl cam thfing vdi ngfldi bfnh lufin dfldc d l cao Giao tie'p cua bac si vdi bfnh n h a n tot se lftm cho ngfldi bfinh ed sfl tin tfldng, hp phd thfie tinh raang eua minh eho thdy thufie, uy tin eua thdy thufie se dflde nftng eao, bfing eon dfldng giao tiep, ngfldi thdy thufi'e, dilu dfldng ed the tifi'p xue vdi ngfldi bfnh tfl kM t i l p n h f n d i n luc r a vifn, qua dd ddng vifin, an ui, cung cd' tinh thdn ngfldi bfinh giup Mfu qua d i l u tri eho ngfldi bfnh eao hdn Dra vdi can bf cfing ehfle ngftnh y, giao t i l p lfi rapt kMa canh the Mfn dao dfle eua ngfldi thdy thufl'c dfli vdi ngfldi bfnh, vdi xa hfli, vdi ddng ngMfp Giao tiep bfte si vdi bfnh nhfin d Bfnh vifn 108 phfl hdp vdi quan dilra cua Austm Q NHAN LQC KHOA HQC X I H Q I vft Searle Iy giai ngfln ngfl khfing cM dflde dflng d l thfing bfto hoftc mifiu ta efti gi dd mft nd thfldng dflde diing de t h i Mfn cfic hfinh dflng Cfte hftnh dflng thflc Mfn bdng ldi dfldc gpi 1ft hanh dan^ ngdn td Cd the ndi rftng, Austm lfi ngfldi dau tifin chu y d i n n M l u chflc nfing dflde thfle hifin bdng eftc phftt ngfin vdi tfl efteh lfi mdt phan cua giao t i l p hfin nhfin Dfic bifit, fing dfi cM rfing, n M l u p h a t ngfln khflng t r u y i n dat thfing tin mfi lfi cfti tfldng dfldng vdi hfinh ddng Cu t h i kM dd ndi: 'Tdi xin loi ", 'Tdi hfla " tM phftt ngfin dd Iftp tfle t r u y i n dat d i n ngfldi nghe KM ndi xm ldi tfle lfi hftnh ddng xin ldi da dflpe thflc Mfin^'^ C a c kifiu g i a o t i e p c u a b a c si vdfi benh nhan Qufi trinh k h a m vfi ehfla bfnh eho bfinh nhfin gfip khd khftn hay t h u f n ldi deu chiu sfl cM phfli, tac dong cua nMeu yeu to' bao gdm yeu to'chii quan vft y l u t l k h a e h quan Sau day, chflng tfii phfin tich cfte kieu hftnh dfng ngfin trung di lftm rd vai trd giao tifi'p gifla bae si vdi bfnh nhfin (1) Hdnh ddng biiu kiin (representatives) 1ft hftnh dfing the Men cfti mft ngfldi ndi tm tfldng Hftnh dfing nfty the Mfn d nhflhg efiu mfi ngfldi ndi phai ehiu trftch nMfm v l gift tri ehfin l;y eua mfnh d l dfldc bifiu dat Vi du, bfte si ndi vdi bfnh nhftm "Cd ve nhfl anh bi dau da dfty rdi" Ngfldi ndi da eam k i t tinh chftn thflc cua raenh d l vdi raflc dp khfte nhau, nhfl lfi xae nhfin, tm tfldng, ke't lufn, phu nhftn, tfldng thuftt Mfle dfi khdng dinh eau: "Tdi dodn anh bi dau dq ddy rSr tMfp hdn cftu: "Tdi khang dinh anh bi dau dq ddy "* NguySn Thien Gi&p (2008), Gido trinh Ngdn ngd hgc, Nxb D^i hoc QuSc gia Hk N§i, tr.377.378 stf 6-2017 NGUYEN THI DUNG Nhdm bieu kifi'n ed t h i bao gdm efte hftnh dfing nhfl; khdng dinh, qud quyit, phdng dodn, miiu td, tfidng bdo, tO choi, tdn thdnh, phdn ddi, gid dinh, gqi y, tranh cdi, hadng Ong, gidi thich Dae trflng cua hfinh dfing bieu k i l n lfi: lfim tft ngft khdp vdi thflc tai, ngfldi ndi tin t m h hud'ng (S tin lfi X) Qua tim hieu, k h a o sftt 50 eufie thoai giao tie'p gifla bfie si vdi bfinh nhan, chflng tfii nhfin thdy hftnh dfing b i i u k i l n rdt da dang phong p h u efte eufic thoai Hftnh dfng bieu kifi'n xuat hifn h d u h i t cftc cufie thoai Ngfldi ndi da eam k i t tinh ehan thflc cua raenh d l vdi nhflng mflc dd khfte n h a u nhfl xftc n h f n : Bftc SI hdi bfinh nhfin: "Anh cd bi sdi kkdng?" bfinh n h a n t r a Idi: "Cd, tdi bi sdi hai ngdy roi " Hay menh d l b i i u Mfn s\$ tin tfldng, kit Man: Bae si ndi vdi bfnh nhftn: "Qua kit qud ehup phim, anh dd bi viem khdp ddu gdi phdi dieu tri ldu ddi vd tich cOc anh a" Mfinh di p h u nhftn, tfldng thufit: Bfinh nhftn ndi vdi bac si: "Hdm qua bi ngd d^c thac phdm, tdi dung thuoc ndy roi nhang kfidng dd " K i t qua k h a o sftt cung eho thdy mflc dp khdng dinh phfit ngfin cua bfie si: "Tdi dodn anh bi gout rdi" thdp hdn so vdi phftt ngon "Tdi khdng dinh anh bi gouf Xet theo ngfl eanh giao tilp d phftt ngfin "Tdi dodn anh bi gout roi", dd Ifi k i t qua khftm lam sang rafi bae si kham cho bfnh nhftn vfi dfla r a phftn doan edn d phat ngfin "Tdi khang dinh ank bigouf, bfte si k i t luftn thfing qua k i t qua kham lam sfing vft xfit nghifm m a u Kfi't qua khao sat eho thdy rdng nhdra hfinh dfng b i i u kifi'n h f i thoai giao t i l p Stffr-Z017 gifla bftc si vdi bfinh nhftn bfnh vifn Qufin y 108 r a t da dang, phong phu Dilu nfiy hoan tofin p h u hdp vdi ngfl eanh giao t i l p mfi efie thoai nhfin t h a m gia (2) Hdnh dgng biiu cdm (expressives): ngfldi ndi t h i hifn t r a n g thfti tftm ly eua minh ddi vdi sfl tinh nfii dung rafnh dl, nhfl xin iBi, phftn nftn, ehuc raflng, cam dn, hoan nghfinh Dfie trflng cua hfinh ddng b i i u cam la: lam tfl ngfl khdp vdi thfle tai, ngfldi ndi cam thdy tinh h u l n g (S cam thdy X) Vdi kfi't qua ehung tfii t h u nhfin dflde qua 50 eufe thoai giao tiep gifla bftc si vdi bfnh nhfin, chung tdi nhftn thdy rdng nhdm hfinh dpng bieu cam xudt Mfn hdu h i t cac cude thoai Nhdm hftnh ddng bieu cam nfty ne'u xudt Mfn phfit ngdn cua bfnh nhftn t h i nd t h i Mfn trang thai tfira Iy eua ngfldi bfnh d ^ vdi sfl tinh ndi dung mfnh d l nhfl: xm ldi, phftn nfin, cam dn, edn vdi phfit ngdn cua bfte si thi nd lai 1ft nfli dung mfinh d l ehue mflng, dpng vifin VI du, bfinh nhftn ndi vdi bae si: "Xin ldi tdi khdng ngke ro tin thuoc, bdc si vui long nhdc lqi", hofie bftc si ndi vdi benh nhftn "Chdc mitng anh Vit mo cua anh phuc hoi rdt tdi, sang tudn anh se daqc xudt viin" (3) Hdnh dgng cdu khiin (directives): ngfldi ndi co' gfing lfim eho ngfldi nghe Iftm cfti gi dd, ehfing b a n hdi, yeu edu, Ifnh, nfii ep, t h i n h cdu xufi't Mfin hdu hfi't phat ngfin cua bac si d eftc eufe thoai Dfie trflng eua hftnh dflng cdu k M i n ia: lftm thfle tai khdp vdi tfl ngfl, ngfldi ndi mufl'n tinh hud'ng (S raud'n }0 Qua k i t qua tim M l u , khao sat 50 eufic thoai giao t i l p gifta bfte si vdi bfnh nhan, chung tfii nhfin thdy hftnh dflng cdu kMen HHAN LQC KHOA HOC XA Htfl [ Q | GIAO TI^P CUA B A C Si V l B | N H NHAN xuat Mfn h d u h i t cftc cufie thoai giao tiep gifla bfie si vdi b f n h nhftn Chdng h a n rafnh d l hdi, yfiu edu, r a Ifnh thufie phftt ngfln eua bftc si cu t h i nhfl: "Anh, chi + bi ldm vdyf" Dd 1ft dang cftu hdi mfi bac si thfldng dung d l hdi bfnh nhftn hay vdi mfinh d l yfiu cau bfie si thfldng diing mftu cftu sau: "Anh, ehi + phdi xet nghiem mdu, fwdc pfidi nhin dn gid trade ndi soi di ndi soi dq ddy, hodc phdi udhg thuoc dung gid, " K i t qua khao sfit eung eho thdy mfinh d l linh hdu nhfl bfie si khfing diing vdi bfnh nhftn Dieu the Mfn sfl thfin tMfin, tfin trpng bfinh nhfin cua bae si Qufin y vifn 108 Vdi nhdm hftnh dfing cdu kMfi'n, sa thinh cdu xufi't Mfn phfit ngdn eua bfinh nhan, eu t h i nhfl: "Bftc si lftm dn khftm cho tdi vdi; Bfiy gid tdi phai Ifim sao? " Dfie trflng cua nhdm hfinh ddng edu kMfi'n lfi: Lfim thfle tai khdp vdi tft ngfl, ngfldi ndi rauon tinh hudng qua khao sfit thfle t l , ehflng tdi nhftn thdy nhdm h a n h ddng cdu kMen hpi thoai giao t i l p gifta bftc si vdi bfnh nhfin, eae h a n h dpng hdi, yeu cau thude v l p h a t ngfin eua bac si Cdn sfl t h i n h edu thufie v l phftt ngdn cua ngfldi bfnh, d i l u hofin tofin phfl hdp vdi ngfl eanh giao tie'p mft hai bfin t h a m gia (4) Hdnh dgng adc kit (commissives): ngfldi ndi eam kfi't rapt h a n h dfing tfldng lai nfio dd, ehdng h£in: bao dam, hfla hpn, eam doan, t h i , tuyen thf Dfc trflng eua hftnh ddng flde kfi't lfi: lfim thfle t£d khdp vdi tfl ngfl, ngfldi ndi dinh t i n h hufi'ng'^' (S dinh }0 Thflc te', hfli thoai giao tiep gifta bfte si vdi bfnh nhftn, nhdm h a n h dpng fldc k i t xudt Mfn phat ngon cua ca bftc si lfin bfnh nhftn Vi du: mfnh QiQ NHAN LUC KHOA HOCXA Htfl di bao dam, hfla h e n bftc si ndi vdi bfnh nhftn: "Anh yfin tfim dieu tri nhfi, se chdng khdi thfii" Cdn mfnh d l cam doan, bfinh nhfin ndi vdi bac si: 'Tdi sfi uong thuoc theo ddn bfie si kfi" Hfinh ddng fldc ke't xuat Mfn h a u h i t cfte cupe thoai (5) Hdnh ddng tuyin bo (declarations) la h a n h dpng ngfldi ndi lftm thay dli dia vi hofe d i l u kifn ben ngofii eua radt ddi tfldng hoftc hoftn eanh chi bfing cftch tao phfit ngdn, nhfl: tfl bd, dfit tfin, sa thai, khai mac Dftc trflng cua hftnh dfing tuyfin bo lfi; tfl ngfl lam thay d l i thflc tai, ngfldi ndi gfiy r a t i n h hufing'^* (S gfty X) Qua khao sfit 50 eude thoai giao tifi'p gifla bae si vdi bfnh nhftn bfnh vifin Trung fldng Quan dpi 108, ehung tfii nhfin thay nhdm hfinh ddng tuyfin bo' cMlm 05/50 cufie thoai, (ti If 10%) Hfinh dpng tuyfin bd' bfic si thfle hifin thfing qua phftt ngdn nhfl bfte si ndi vdi bfnh nhfin: "Chi hi cum rdi"; "Anh bi dau dq ddy", Cfie hfinh dfing ngfin trung nhfl trfin v l trang thfti tftm ly dflde bieu hifn cu the nhfl sau: Trong hftnh dpng bieu kien, trang thfti t a m ly ciia ngfldi ndi 1ft phai ed ldng tin vfio mfinh d l dflde ndi Trong hfinh dpng edu kMen, t r a n g thai tfim Iy 1ft raong mufi'n ngfldi nghe thflc Mfin hftnh ddng Trong h a n h ddng h i l u cam, trang thfti tftm ly ngfldi ndi, ngfldi nghe phu thude vfio mue dieh eua hftnh ddng ngfin tfl Trong hfinh dpng fldc ke't, t r a n g thai tftm ly cua ngfldi ndi lfi dinh lftm eai gi dd