Physicians' Perceptions and Suggestions for the Adaptation of a US-Based Serious Illness Communication Training in a Non-US Culture: A Qualitative Study.
Physicians' Perceptions and Suggestions for the Adaptation of a US-Based Serious Illness Communication Training in a Non-US Culture: A Qualitative Study.
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DOI：
10.1016/j.jpainsymman.2020.11.035
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发表时间：
2021-08
影响因子：
4.7
通讯作者：
Ouchi K
中科院分区：
文献类型：
--
作者：
Onishi E;Nakagawa S;Uemura T;Shiozawa Y;Yuasa M;Ito K;Kobayashi Y;Ishikawa H;Ouchi K
美国的大病沟通培训教学法在美国以外的地方还没有得到很好的研究。探索在非美国文化中对以美国为基础的严重疾病沟通培训教学法的看法，并确定需要文化适应的方面。2019年9月，我们在日本东京的两个城市学术医疗中心使用方便抽样进行了定性研究。对参加了四个小时的日语VitalTalk培训的日本医生进行了半结构化访谈。我们探讨了六个主题：1)对培训的整体印象；2)参与的主要目标；3)教学的适当性；4)角色扮演体验；5)从培训中获得分数；6)培训后自己的交流实践的变化。访谈被转录、编码，并使用现象学方法进行分析。所有24名参与者都认为VitalTalk的教学方法新颖而有益，他们强调了展示同理心、反思自己技能的重要性，并认识到强调使用特定词语的反馈的重要性。与会者还指出，日本患者一般不会明确表达自己的强烈情绪。我们的研究发现，经验证据表明，VitalTalk教学法在非美国文化背景下被认为是新颖和有益的。为了最大限度地发挥其在日本的功效，可能需要在表达和对情感的反应方面进行文化适应。为了满足日本临床实践的需要，还需要进一步的研究来对VitalTalk教学法所建议的改进进行实证测试。
US-based serious illness communication training pedagogy has not been well studied outside of the United States. To explore the perception of a US-based, serious illness communication training pedagogy in a non-US culture and to identify aspects requiring cultural adaptations. In September 2019, we conducted a qualitative study using convenient sampling at two urban, academic medical centers in Tokyo, Japan. Semistructured interviews were conducted to japanese physicians who participated in the four-hour VitalTalk training in Japanese. We explored six majored themes: 1) global impression of the training; 2) main goals from participation; 3) appropriateness of didactics; 4) role play experiences; 5) take away points from the training; and 6) changes in their own communication practice after the training. Interviews were transcribed, coded, and analyzed using phenomenological approach. All 24 participants found the VitalTalk pedagogy novel and beneficial, stressing the importance of demonstrating empathy, reflecting on own skills, and recognizing the importance of feedback that emphasizes the use of specific words. Participants also pointed out that Japanese patients generally do not express their strong emotions explicitly. Our study found empirical evidence that the VitalTalk pedagogy is perceived to be novel and beneficial in a non-US cultural setting. Cultural adaptations in expression and response to emotion may be required to maximize its efficacy in Japan. To meet the needs of clinical practice in Japan, further studies are needed to empirically test the suggested refinements for the VitalTalk pedagogy.
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