Reducing Health Disparities at End of Life

描述(由申请者提供)：该项目将扩大互动的、基于网络的培训材料，旨在提高临床医生和来自不同人群的患者之间的沟通效率，以提高生命末期的卫生保健质量。这项研究的目的是描述基于网络的文化和生命终结计划对以下方面的影响：患者对沟通质量的评分、患者焦虑和对临床医生的信任。此外，临床医生将评估临床医生与患者交流的基于内容的编码，并由临床医生自我评估文化能力分数。我们的跨学科研究团队将招募40名初级保健临床医生和每名临床医生1-3名患者。初级保健临床医生将被随机分配到基于网络的文化和生命终结计划或等待名单控制中。患者将完成问卷调查，评估临床医生在进行文化上一致的临终讨论方面的技能，并将他们与临床医生的互动录制下来。这项研究将促进探索性和发展性研究，以解决当前卫生保健系统中已记录在案的需求：加强文化上一致的临终沟通。公共卫生相关性：该项目将扩大互动的、基于网络的培训材料，旨在提高临床医生和来自不同人群的患者之间的沟通效率，以提高临终保健的质量。该项目将评估对初级卫生临床医生的网络培训对患者评估的临终沟通质量的影响，以及临床医生与患者沟通的基于内容的编码。

DESCRIPTION (provided by applicant): This project will expand interactive, web-based training materials designed to improve the effectiveness of communication between clinicians and patients from diverse populations, in order to improve the quality of health care at end of life. The aim of this study is to describe the effects of the web-based Culture & End of Life program on: Patient ratings of quality of communication, patient anxiety, and trust in the clinician. Additionally, content-based coding of clinician communication with patients will be assessed and cultural competence scores self-assessed by clinicians. Our interdisciplinary research team will recruit 40 primary care clinician and 1-3 patients per clinician. Primary care clinicians will be randomized to either the web-based Culture & End of Life program or to a wait list control. Patients will complete questionnaires assessing the clinicians' skill at having culturally congruent end-of-life discussions and have their interaction with their clinician audio-taped. This study will stimulate exploratory and developmental research that addresses a documented need in the current health care system: that of enhancing culturally congruent end of life communication. PUBLIC HEALTH RELEVANCE: This project will expand interactive, web-based training materials designed to improve the effectiveness of communication between clinicians and patients from diverse populations, in order to improve the quality of health care at end of life. This project will evaluate the effect of the web-based training for primary health clinicians on quality of end of life communication as assessed by patients and with content-based coding of clinician communication with patients.