Communication Skills Training for Physicians Improves Patient Satisfaction
Communication Skills Training for Physicians Improves Patient Satisfaction
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DOI：
10.1007/s11606-016-3597-2
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发表时间：
2016-07-01
影响因子：
5.7
通讯作者：
Rothberg, Michael B.
中科院分区：
文献类型：
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作者：
Boissy, Adrienne;Windover, Amy K.;Rothberg, Michael B.
背景：熟练的医生沟通是患者体验的关键组成部分。尚未进行关于接触沟通技巧培训及其对患者满意度影响的大规模研究。目的：我们旨在研究以体验式关系为中心的医生沟通技巧培训对患者满意度和医生体验的影响。设计：这是一项观察性研究。背景：该研究在大型多专业学术医疗中心进行。参与者：参与者包括 1537 名参加过沟通技巧培训的主治医生和 1951 名未参加沟通技巧培训的医生。 2013 年 8 月 1 日和 2014 年 4 月 30 日。干预：使用以关系为中心的模型进行 8 小时的互动教学、现场或视频技能演示以及小组和大型小组技能练习课程。主要措施：医疗保健提供者和系统的医院消费者评估 (HCAHPS)、医疗保健提供者和系统的临床医生和团体消费者评估 (CGCAHPS)、杰斐逊同理心量表 (JSE)、 Maslach 倦怠量表 (MBI)、自我效能和课程后满意度。 主要结果：课程结束后，干预医生的医生沟通调整后总体 CGCAHPS 得分高于对照组（92.09 与 91.09，p < 0.03）。医生专业或基线 CGCAHPS 与课程后的改善之间没有发现显着的相互作用。与对照组相比，干预组的课后 HCAHPS 尊重域调整平均值显着改善（91.08 vs. 88.79，p = 0.02），调整后的 HCAHPS 沟通分数也有较小的非统计显着性改善（83.95 vs. 82.73，p = 0.22）。医生报告了很高的课程满意度，并且在同理心（116.4 +/- 12.7 vs. 124 +/- 11.9，p < 0.001）和倦怠方面表现出显着改善，包括情绪耗竭、人格解体和个人成就的所有衡量标准。更少的人格解体和更高的个人成就持续了至少 3 个月。结论：以关系为中心的全系统沟通技巧培训提高了患者满意度评分，提高了医生的同理心和自我效能，并减少了医生的倦怠。有必要进行进一步的研究来检验此类干预措施的长期可持续性。
BACKGROUND: Skilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted.OBJECTIVE: We aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience.DESIGN: This was an observational study.SETTING: The study was conducted at a large, multispecialty academic medical center.PARTICIPANTS: Participants included 1537 attending physicians who participated in, and 1951 physicians who did not participate in, communication skills training between 1 August 2013 and 30 April 2014.INTERVENTION: An 8-h block of interactive didactics, live or video skill demonstrations, and small group and large group skills practice sessions using a relationship-centered model.MAIN MEASURES: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), Jefferson Scale of Empathy (JSE), Maslach Burnout Inventory (MBI), self-efficacy, and post course satisfaction.KEY RESULTS: Following the course, adjusted overall CGCAHPS scores for physician communication were higher for intervention physicians than for controls (92.09 vs. 91.09, p < 0.03). No significant interactions were noted between physician specialty or baseline CGCAHPS and improvement following the course. Significant improvement in the post-course HCAHPS Respect domain adjusted mean was seen in intervention versus control groups (91.08 vs. 88.79, p = 0.02) and smaller, non-statistically significant improvements were also seen for adjusted HCAHPS communication scores (83.95 vs. 82.73, p = 0.22). Physicians reported high course satisfaction and showed significant improvement in empathy (116.4 +/- 12.7 vs. 124 +/- 11.9, p < 0.001) and burnout, including all measures of emotional exhaustion, depersonalization, and personal accomplishment. Less depersonalization and greater personal accomplishment were sustained for at least 3 months.CONCLUSIONS: System-wide relationship-centered communication skills training improved patient satisfaction scores, improved physician empathy, self-efficacy, and reduced physician burnout. Further research is necessary to examine longer-term sustainability of such interventions.