Evaluation of Physician and Nurse Dyad Training Procedures to Deliver a Palliative and End-of-Life Communication Intervention to Parents of Children with a Brain Tumor
Evaluation of Physician and Nurse Dyad Training Procedures to Deliver a Palliative and End-of-Life Communication Intervention to Parents of Children with a Brain Tumor
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DOI：
10.1177/1043454214563410
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发表时间：
2015-09-01
影响因子：
1.7
通讯作者：
Haase, Joan E.
中科院分区：
文献类型：
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作者：
Hendricks-Ferguson, Verna L.;Kane, Javier R.;Haase, Joan E.
当一个孩子的预后很差，医生和护士（MD/RN）往往挣扎着在疾病轨迹的早期开始讨论姑息治疗和临终关怀（PC/EOL）。我们描述了用于准备MD/RN二人组提供干预的培训程序的评估，该干预名为：沟通计划：早期至生命结束（COMPHENTS）干预。我们的培训由一个专家顾问团队（即，医学伦理学、沟通和PC/EOL）和家长顾问。虽然有一半的人接受了为期1天的培训，另一半接受了为期2天的培训，但所有参与者的内容包括4个模块：家庭评估、目标导向的治疗计划、预期指导以及员工沟通和随访。评价包括对每个模块的内容、反思和技能实践的二分评级和定性评论。我们的培训的积极方面包括家长顾问的见解，强调希望和不放弃的信息，书面材料，以促进PC/EOL沟通，和MD/RN二元方法。将介绍与我们的培训程序相关的经验教训和挑战。总的来说，MD和RN报告说，我们的PC/EOL沟通培训程序是有帮助和有用的。未来的研究者应仔细计划PC/EOL沟通干预的培训程序。
When a child's prognosis is poor, physicians and nurses (MDs/RNs) often struggle with initiating discussions about palliative and end-of-life care (PC/EOL) early in the course of illness trajectory. We describe evaluation of training procedures used to prepare MD/RN dyads to deliver an intervention entitled: Communication Plan: Early Through End of Life (COMPLETE) intervention. Our training was delivered to 5 pediatric neuro-oncologists and 8 pediatric nurses by a team of expert consultants (i.e., in medical ethics, communication, and PC/EOL) and parent advisors. Although half of the group received training in a 1-day program and half in a 2-day program, content for all participants included 4 modules: family assessment, goal-directed treatment planning, anticipatory guidance, and staff communication and follow-up. Evaluations included dichotomous ratings and qualitative comments on content, reflection, and skills practice for each module. Positive aspects of our training included parent advisers' insights, emphasis on hope and non-abandonment messages, written materials to facilitate PC/EOL communication, and an MD/RN dyad approach. Lessons learned and challenges related to our training procedures will be described. Overall, the MDs and RNs reported that our PC/EOL communication-training procedures were helpful and useful. Future investigators should carefully plan training procedures for PC/EOL communication interventions.