Development and preliminary evaluation of communication skills training program for oncologists based on patient preferences for communicating bad news
Development and preliminary evaluation of communication skills training program for oncologists based on patient preferences for communicating bad news
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DOI：
10.1017/s147895151300031x
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发表时间：
2014-10-01
影响因子：
2.2
通讯作者：
Uchitomi, Yosuke
中科院分区：
文献类型：
--
作者：
Fujimori, Maiko;Shirai, Yuki;Uchitomi, Yosuke
目的：本研究的目的是根据患者偏好制定沟通技巧培训（CST）研讨会计划，并根据医生在 CST 前后的客观表现和对与患者沟通的信心的主观评分来评估 CST 计划的初步可行性。方法：CST 计划是在之前对患者偏好的调查基础上制定的（设置访谈的支持环境，考虑如何传达坏消息，讨论附加信息，并提供保证）和情感支持）并通过移情反应解决患者的情绪，并强调肿瘤科医生的情感支持。该项目以参与者为中心，包括教学讲座、与模拟患者的角色扮演、讨论和破冰活动；总共2天。为了评估新开发的 CST 计划的可行性，参与该计划的肿瘤科医生在 CST 前后的模拟咨询期间评估了他们的沟通表现（行为和言语）。参与者还评估了他们在 CST 前、后和 CST 后 3 个月与患者沟通的信心，CST 前和 CST 后 3 个月的倦怠，以及 CST 后该计划的帮助性。结果：16 名肿瘤科医生参加了新开发的 CST。前后测量的比较显示肿瘤学家的沟通表现有所改善，特别是情感支持和考虑如何传递信息的技能。他们对传达坏消息的信心在 CST 后的得分高于 CST 前的得分，并且在 CST 后的 3 个月内持续存在。 CST 后 3 个月，情绪疲惫分数下降。此外，肿瘤科医生对该计划的所有组成部分都给予了很高的满意度。 结果的意义：这项试点研究表明，基于患者偏好的新开发的 CST 计划似乎是可行的，并且可能有效地改善肿瘤科医生的患者偏好的沟通行为以及与患者沟通的信心。
Objective: The purposes of this study were to develop a communication skills training (CST) workshop program based on patient preferences, and to evaluate preliminary feasibility of the CST program on the objective performances of physicians and the subjective ratings of their confidence about the communication with patients at the pre-and post-CST.Methods: The CST program was developed, based on the previous surveys on patient preferences (setting up the supporting environment of the interview, making consideration for how to deliver bad news, discussing about additional information, and provision of reassurance and emotional support) and addressing the patient's emotion with empathic responses, and stressing the oncologists' emotional support. The program was participants' centered approach, consisted a didactic lecture, role plays with simulated patients, discussions and an ice-breaking; a total of 2-days. To evaluate feasibility of the newly developed CST program, oncologists who participated it were assessed their communication performances (behaviors and utterances) during simulated consultation at the pre-and post-CST. Participants also rated their confidence communicating with patients at the pre-, post-, and 3-months after CST, burnout at pre and 3 months after CST, and the helpfulness of the program at post-CST.Results: Sixteen oncologists attended a newly developed CST. A comparison of pre-post measures showed improvement of oncologists' communication performances, especially skills of emotional support and consideration for how to deliver information. Their confidence in communicating bad news was rated higher score at post-CST than at pre-CST and was persisted at 3-months after the CST. Emotional exhaustion scores decreased at 3-months after CST. In addition, oncologists rated high satisfaction with all components of the program.Significance of results: This pilot study suggests that the newly developed CST program based on patient preferences seemed feasible and potentially effective on improving oncologists' communication behaviors what patients prefer and confidence in communicating with patients.