Provider Training in Empathic Communication Skills to Reduce Lung Cancer Stigma

项目摘要 大多数（95%）的肺癌患者报告说，他们的家人对肺癌有偏见， 朋友和医疗服务提供者，48%的人特别报告说，他们的医疗服务 提供商污名对患者的心理健康以及他们的医疗结果有负面影响。 在临床咨询的背景下，污名可能会加剧，在这种情况下，医生通常会探讨 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共情交流 接触可能会减少感知的耻辱和改善其他病人的结果。本研究的目标是： 1)调整沟通技能培训模块，重点是同理心医生沟通; 2） 检查共情医生沟通技能培训干预的可行性和可接受性， 胸部肿瘤科医师; 3）试点测试适应移情医生沟通技能培训的效果 对患者报告的耻辱（主要），医生同情，沟通满意度， 心理困扰，以及患者接受转介到心理社会和/或烟草的图表审核 戒烟支持服务。为了实现这些目标，我们将调整现有的移情医生沟通 MSK的沟通技能培训和研究实验室开发的技能培训模块，以满足 医生治疗患者的特定吸烟和与耻辱相关的沟通问题 肺癌接下来，我们将确定胸部肿瘤医生（n=30）的培训完成率， 培训模块评估以及移情沟通技能吸收的前后变化， 视频记录和编码标准化的病人遭遇。为了评估共情的潜在好处， 关于患者报告结局的沟通技能模块，每名参与者6名患者（有吸烟史） 医生（3名患者在医生完成培训之前，3名患者在培训之后）将 完整的肺癌耻辱感，同情心，沟通满意度的测量， 心理困扰此外，将在培训前和培训后检查电子病历， 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。是 预计这些试点测试结果将提供证据的可行性，可接受性和承诺， 沟通技能培训干预，以改善医生的移情沟通，从而减少 肺癌的治疗方法有哪些

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.