Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers.
Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers.
复制标题
DOI：
10.1007/s00520-015-2656-2
复制
发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Tulsky JA
中科院分区：
文献类型：
--
作者：
Porter LS;Pollak KI;Farrell D;Cooper M;Arnold RM;Jeffreys AS;Tulsky JA
患者往往难以向肿瘤提供者表达他们的情感担忧，因此可能会遇到未满足的需求。本文介绍了一个在线程序的开发和实施，教患者如何沟通他们的情绪，他们的肿瘤提供者。该干预措施由一个多学科团队开发，该团队由姑息治疗医生，心理学家和干预软件开发人员组成，并包括患者的输入。它结合了社会认知理论的元素，并验证了沟通技能培训的认知行为策略。增加干预依从性的策略在研究中途实施。该干预包括四个互动的在线模块，以教授患者向其提供者表达情感担忧和寻求支持的策略。除了技能培养外，干预措施还旨在提高患者的期望，即向提供者表达情感关切会有所帮助，提高他们这样做的自我效能，并帮助他们克服进行这些对话的障碍。在实施提高依从性的策略后，使用率从47%增加到64%。这种干预解决了晚期癌症患者未满足的教育需求。增加依从性的策略导致老年患者人群的使用率提高。我们目前正在随机临床试验中评估干预措施，以确定其在增加患者情感表达和支持请求方面的有效性。如果成功，这种干预可以作为未来在线患者教育计划的模式。
Patients often struggle to express their emotional concerns to their oncology providers, and may therefore experience unmet needs. This paper describes the development and implementation of an online program that teaches patients how to communicate their emotions to their oncology providers. The intervention was developed by a multidisciplinary team consisting of palliative care physicians, psychologists, and an intervention software developer, and included input from patients. It incorporated elements of Social Cognitive Theory and validated cognitive behavioral strategies for communication skills training. Strategies to increase intervention adherence were implemented midway through the study. The intervention consists of four interactive, online modules to teach patients strategies for expressing emotional concerns to their providers and asking for support. In addition to skill-building, the intervention was designed to raise patients’ expectations that expressing emotional concerns to providers would be helpful, to enhance their self-efficacy for doing so, and to help them overcome barriers to having these conversations. After implementing strategies to improve adherence, usage rates increased from 47% to 64%. This intervention addresses an unmet educational need for patients with advanced cancer. Strategies to increase adherence led to improvements in usage rates in this population of older patients. We are currently evaluating the intervention in a randomized clinical trial to determine its efficacy in increasing patient expression of emotional concerns and requests for support. If successful, this intervention could serve as a model for future online patient education programs.