Training residents to employ self-efficacy-enhancing interviewing techniques: randomized controlled trial of a standardized patient intervention.
Training residents to employ self-efficacy-enhancing interviewing techniques: randomized controlled trial of a standardized patient intervention.
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DOI：
10.1007/s11606-009-0946-4
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发表时间：
2009-05
影响因子：
5.7
通讯作者：
Franks, Peter
中科院分区：
文献类型：
--
作者：
Jerant, Anthony;Kravitz, Richard L.;Azari, Rahman;White, Lynda;Garcia, Jorge A.;Vierra, Heather;Virata, Maria Catrina;Franks, Peter
关键词：
目前提高患者自我效能（健康行为的关键调节因素）的干预措施限制了初级保健的应用。探讨以办公室为基础的干预措施的有效性，以培训住院医师使用自我效能增强访谈技术（参见 IT）。随机对照试验。学术医疗中心的家庭医学和内科住院医生 (N = 64)。住院医师对 SEE IT 的使用（计数十种可能的行为）是根据两次标准化患者 (SP) 教练培训访问和两次未经通知的培训后 SP 访问的医患部分的录音进行编码的，所有这些都涉及常见的身心健康状况和行为改变问题。一次培训后 SP 访问涉及与培训中经历的类似的健康状况，而另一次则涉及新的状况。从第一次培训访问后开始一直到最后一次培训后访问，实验组居民对 SEE IT 的使用明显多于对照组。干预措施的平均效果显着[调整后的 SEE IT 使用增加的发生率 = 1.94（95% 置信区间 = 1.34, 2.79；p < 0.001）]。居民性别、种族/民族、专业、培训水平或 SP 健康状况没有显着影响。 SP 讲师可以教住院医生在 SP 办公室访问期间应用 SEE IT，其影响范围超出了用于培训的范围。未来的研究应探讨干预措施对执业医师的影响、医师在实际患者就诊期间使用 SEE IT 的效果，及其对患者健康行为和结果的影响。
Current interventions to enhance patient self-efficacy, a key mediator of health behavior, have limited primary care application. To explore the effectiveness of an office-based intervention for training resident physicians to use self-efficacy-enhancing interviewing techniques (SEE IT). Randomized controlled trial. Family medicine and internal medicine resident physicians (N = 64) at an academic medical center. Resident use of SEE IT (a count of ten possible behaviors) was coded from audio recordings of the physician-patient portion of two standardized patient (SP) instructor training visits and two unannounced post-training SP visits, all involving common physical and mental health conditions and behavior change issues. One post-training SP visit involved health conditions similar to those experienced in training, while the other involved new conditions. Experimental group residents demonstrated significantly greater use of SEE IT than controls, starting after the first training visit and sustained through the final post-training visit. The mean effect of the intervention was significant [adjusted incidence rate ratio for increased use of SEE IT = 1.94 (95% confidence interval = 1.34, 2.79; p < 0.001)]. There were no significant effects of resident gender, race/ethnicity, specialty, training level, or SP health conditions. SP instructors can teach resident physicians to apply SEE IT during SP office visits, and the effects extend to health conditions beyond those used for training. Future studies should explore the effects of the intervention on practicing physicians, physician use of SEE IT during actual patient visits, and its influence on patient health behaviors and outcomes.
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影响因子：
7
作者：
Egede, Leonard E.
通讯作者：
Egede, Leonard E.
影响因子：
3.4
作者：
Franz, Carol E.;Epstein, Ron;Kravitz, Richard L.
通讯作者：
Kravitz, Richard L.
影响因子：
2.6
作者：
Kobau, R;DiIorio, C
通讯作者：
DiIorio, C
影响因子：
--
作者：
Brody, BL;Roch-Levecq, AC;Brown, SI
通讯作者：
Brown, SI
影响因子：
2.8
作者：
DICLEMENTE, CC;PROCHASKA, JO;GIBERTINI, M
通讯作者：
GIBERTINI, M