Empathic communication skills training to reduce lung cancer stigma in Nigeria

尼日利亚开展同理心沟通技巧培训以减少肺癌耻辱感

• 批准号: 10406392
• 负责人: CRAIG B THOMPSON
• 金额: $ 21.36万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10406392
• 关键词: Address; Africa; Africa South of the Sahara; Blinded; Cancer Etiology; Cancer Patient; Caring; Cessation of life; Client satisfaction; Clinical; Clinical Trials; Code; Communication; Complex; Country; Coupled; Educational Intervention; Effectiveness; Empathy; Equipment and supply inventories; Evaluation; Feedback; Focus Groups; Foundations; Frequencies; Funding; Goals; Grant; Group Interviews; Health behavior; Hospitals; Hour; Intervention; Interview; Malignant Neoplasms; Malignant neoplasm of lung; Measurement; Measures; Medical; Memorial Sloan-Kettering Cancer Center; Methods; Nature; Nigeria; Nigerian; Oncology; Participant; Patient Outcomes Assessments; Patient Representative; Patients; Perception; Personal Satisfaction; Provider; Reporting; Research; Research Personnel; Self Efficacy; Smoking; Smoking Behavior; Smoking History; Standardization; Stigmatization; Symptoms; Teaching Hospitals; Tobacco; Training; Training Activity; Universities; Visit; Woman; Work; acceptability and feasibility; cancer care; care providers; clinical encounter; cognitive interview; college; design; effective intervention; evidence base; experience; feasibility testing; improved; low and middle-income countries; men; patient oriented; public health relevance; recruit; skills; skills training; smoking prevalence; smoking-related cancer; social stigma; success; therapy design; tool; uptake

Project Summary Lung cancer is the leading cause of cancer-related deaths in men and women worldwide, and approximately 70% of these deaths occur in low- and middle-income countries (LMICs). Prior research in sub-Saharan Africa (SSA) indicates that lung cancer became the 3rd most common cancer in men in 2015-2018, unfortunately characterized by late stage presentation (Stages 3 and 4) with 75% patients seeking medical care only at advanced stages. Among the many factors that deter seeking medical treatment for lung cancer is stigma, particularly anticipated lung cancer stigma during medical encounters. Our prior NCI-funded cancer stigma work has developed a patient-reported measure of lung cancer stigma (Lung Cancer Stigma Inventory – LCSI) and demonstrated that stigma experienced during encounters with oncology care providers (OCPs) contributes to delays in symptom presentation and initiation of treatment in lung cancer. One way to mitigate perceived stigma experienced by patients with lung cancer is enactment of empathic communication during medical visits. We have recently developed an Empathic Communication Skills (ECS) training module at Memorial Sloan Kettering Cancer Center in the USA. The ECS training module focuses on addressing communication challenges inherent in OCPs’ discussions of smoking behavior and history with lung cancer patients and represents a promising approach to reduce lung cancer stigma. Preliminary studies using the ECS training have shown encouraging results in improving communication among OCPs and improving patient satisfaction. The current proposal is designed to examine lung cancer stigma in patients in Nigeria and adapt the ECS for use in Nigerian cancer care settings. The aims of the study are (a) to adapt for cultural and regional relevance a patient-reported tool for measurement of lung cancer stigma and an empathic communication skills (N-ECS) training for use with OCPs who treat patients with lung cancer by assessing the nature and frequency of stigma experiences by patients with lung cancer in Nigeria, and (b) to examine the feasibility and acceptability of the N-ECS training among OCPs who treat patients with lung cancer in Nigeria. For Aim 1, study investigators will adapt the LCSI and the ECS training module to include lung cancer-specific clinical vignettes and other training materials (trigger videos) that portray stigmatizing interactions using patient-centered feedback from 20 lung cancer patient representatives from University College Hospital, Ibadan, Nigeria and Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. For Aim 2, 25 OCPs will be recruited from the same hospitals to participate in the 2-hour N-ECS training, and complete measures of training evaluation and self-efficacy. For objective measurement of skill uptake, participants will complete standardized patient assessments (SPAs) coded by blinded staff from the MPIs’ labs. The study also seeks to build capacity for a planned multi-level clinical trial to mitigate lung cancer stigma in Nigeria by developing the N-ECS, building upon the success of high-quality, evidence-based ECS training in the USA.

项目概要 肺癌是全世界男性和女性癌症相关死亡的主要原因，大约 其中 70% 的死亡发生在低收入和中等收入国家 (LMIC)。撒哈拉以南非洲地区的先前研究 (SSA) 不幸的是，肺癌在 2015-2018 年成为男性第三大常见癌症 其特点是晚期表现（第 3 和第 4 阶段），75% 的患者仅在 高级阶段。阻碍肺癌就医的众多因素之一是耻辱感， 在医疗过程中特别预期肺癌的耻辱感。我们之前由 NCI 资助的癌症耻辱 研究人员开发了一种患者报告的肺癌耻辱感测量方法（肺癌耻辱感清单 - LCSI） 并证明在与肿瘤护理提供者 (OCP) 接触时经历的耻辱有助于 肺癌症状出现和开始治疗的延迟。减轻感知的一种方法 肺癌患者经历的耻辱是医疗过程中同理心沟通的体现 访问。我们最近在纪念馆开发了同理心沟通技巧（ECS）培训模块 美国斯隆凯特琳癌症中心。 ECS 培训模块侧重于解决沟通问题 OCP 与肺癌患者讨论吸烟行为和病史所固有的挑战 代表了一种减少肺癌耻辱感的有前途的方法。使用 ECS 训练的初步研究表明 在改善 OCP 之间的沟通和提高患者满意度方面显示出令人鼓舞的结果。这 目前的提案旨在检查尼日利亚患者的肺癌耻辱感，并调整 ECS 以用于 尼日利亚癌症护理机构。该研究的目的是 (a) 适应文化和区域相关性 患者报告的用于测量肺癌耻辱感和同理心沟通技巧的工具（N-ECS） 通过评估耻辱的性质和频率来治疗肺癌患者的 OCP 的使用培训 尼日利亚肺癌患者的经验，以及 (b) 检查该方案的可行性和可接受性 在尼日利亚，为治疗肺癌患者的 OCP 提供 N-ECS 培训。对于目标 1，研究人员将 调整 LCSI 和 ECS 培训模块，以包括肺癌特定的临床小插曲和其他内容 培训材料（触发视频），利用以患者为中心的反馈来描绘侮辱性互动 来自尼日利亚伊巴丹大学学院医院和奥巴费米的20名肺癌患者代表 尼日利亚伊费岛阿沃洛沃大学教学医院大楼。对于目标 2，将从以下机构招募 25 名 OCP： 同一医院参加2小时的N-ECS培训，并完成培训评估和措施 自我效能感。为了客观衡量技能的掌握情况，参与者将完成标准化患者 由 MPI 实验室的盲人工作人员编写的评估 (SPA)。该研究还旨在培养以下方面的能力： 计划进行多层次临床试验，通过开发 N-ECS 来减轻尼日利亚肺癌的耻辱感，建立 基于美国高质量、循证 ECS 培训的成功。