Provider Training in Empathic Communication Skills to Reduce Lung Cancer Stigma

提供者进行移情沟通技巧培训以减少肺癌耻辱感

• 批准号: 9326263
• 负责人: Smita Banerjee
• 金额: $ 22.37万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9326263
• 关键词: Address; Adherence; Cancer Patient; Caring; Chest; Client satisfaction; Clinical; Code; Communication; Computerized Medical Record; Consultations; Diagnosis; Educational Intervention; Effectiveness; Empathy; Evaluation; Family; Foundations; Friends; Funding Opportunities; Goals; Grant; Health; Intervention; Lead; Malignant neoplasm of lung; Measures; Medical; Memorial Sloan-Kettering Cancer Center; Methods; Oncologist; Outcome; Patient Outcomes Assessments; Patient Recruitments; Patient-Focused Outcomes; Patients; Perception; Physicians; Population; Provider; Psychiatric Social Work; Psychosocial Assessment and Care; Reporting; Research; Services; Smoking; Smoking Behavior; Smoking History; Smoking Status; Standardization; Stigmatization; Symptoms; Testing; Thoracic Oncology; Tobacco; Tobacco Use Cessation; Tobacco-Related Carcinoma; Training; Training Activity; United States National Institutes of Health; cancer care; clinical care; clinically relevant; design; effective intervention; experience; help-seeking behavior; improved; programs; psychologic; psychological distress; psychological outcomes; psychosocial; public health relevance; response; satisfaction; skills; skills training; smoking cessation; social stigma; therapy design; treatment program; uptake

PROJECT SUMMARY The majority (95%) of lung cancer patients report experiencing lung cancer stigma from their family, friends, and medical providers, with 48% specifically reporting experiencing stigma from their medical providers. Stigma has negative effects on patients’ psychological well-being as well as their medical outcomes. Stigma may be exacerbated within the context of clinical consultations in which physicians routinely probe about patients’ smoking history and current smoking status. Empathic communication during these clinical encounters may reduce perceived stigma and improve other patient outcomes. The goals of this study are to: 1) To adapt a communication skills training module focusing on empathic physician communication; 2) examine the feasibility and acceptability of the empathic physician communication skills training intervention for thoracic oncologists; and 3) pilot test the effect of the adapted empathic physician communication skills training intervention on patient-reported stigma (primary), physician empathy, satisfaction with communication, psychological distress, and chart audit of patient acceptance of referral to psychosocial and/or tobacco cessation support services. To meet these goals, we will adapt an existing empathic physician communication skills training module developed by MSK’s Communication Skills Training and Research Lab to meet the specific smoking and stigma-related communication issues experienced by physicians treating patients with lung cancer. Next, we will determine thoracic oncology physicians’ (n=30) rate of completion of the training, training module evaluation as well as pre- and post-changes in empathic communication skill uptake with video-recorded and coded standardized patient encounters. To estimate the potential benefit of the empathic communication skills module on patient reported outcomes, six patients (with smoking history) per participating physician (3 patients before the physician has completed the training and 3 patients after the training) will complete measures of perceived lung cancer stigma, perceived empathy, satisfaction with communication, and psychological distress. Additionally, electronic medical records will be examined pre- and post-training to examine rates of accepted referrals to the Tobacco Treatment Program and other psychosocial services. It is expected that these pilot test findings will provide evidence for the feasibility, acceptability and promise of a communication skills training intervention to improve physicians’ empathic communication and thereby reduce stigma experienced by patients with lung cancer.

项目总结 大多数(95%)的肺癌患者报告说，他们经历了家人对肺癌的耻辱， 朋友和医疗提供者，48%的人特别报告说他们的医疗服务带来了耻辱 供应商。耻辱对患者的心理健康和医疗结果都有负面影响。 耻辱可能在临床会诊的背景下加剧，在临床会诊中，医生通常会探查 了解患者的吸烟史和目前的吸烟状况。在这些临床过程中的移情交流 相遇可能会减少被认为的耻辱，并改善其他患者的预后。这项研究的目标是： 1)调整以移情医生沟通为重点的沟通技能培训模块；2) 考察移情医师沟通技能培训干预的可行性和可接受性 胸肿瘤学家；3)初步测试适应的同理心医生沟通技能培训的效果 对患者报告的污名的干预(主要)，医生的同理心，沟通的满意度， 心理困扰，以及患者接受心理社会和/或烟草转诊的图表审计 戒烟支持服务。为了实现这些目标，我们将调整现有的同理心医生的沟通方式 由MSK沟通技能培训和研究实验室开发的技能培训模块，以满足 治疗慢性阻塞性肺疾病患者的医生所经历的特定的吸烟和污名相关的沟通问题 肺癌。接下来，我们将确定胸科肿瘤医生(n=30)的培训完成率， 培训模块评估以及变化前后的同理心沟通技能培养 视频记录和编码的标准化患者会诊。估计移情的潜在益处 关于患者报告结果的沟通技能模块，每次参与6名患者(有吸烟史) 医生(医生完成培训前3名患者和培训后3名患者)将 完整测量感受到的肺癌污名、感受到的同理心、对沟通的满意度，以及 心理上的痛苦。此外，将在培训前和培训后审查电子病历，以 检查接受转介到烟草治疗计划和其他心理社会服务的比率。它是 预计这些试点测试结果将提供证据，证明 沟通技能训练干预改善医生的共情沟通，从而减少 肺癌患者所经历的耻辱。