Improving Patient-Centered Communication and Cancer Care

描述(由申请人提供)：癌症患者及其家人继续报告与其医护人员在诊断、疾病进展、关于治疗和程序的教育、转介服务和心理社会护理方面的沟通不足。考虑到他们与患者和家人接触的增加，以及他们提供的护理的亲密性，肿瘤科护士往往容易受到患者/家人关于这些话题的讨论。虽然国家议程和护理标准指南强调了癌症护理过程中沟通的重要性，但护士们报告说，在透露坏消息时感到不舒服，缺乏关于癌症生存的知识，难以讨论精神和性问题，以及错过了将癌症患者转介到临终关怀中心的机会。拟议的癌症教育计划将通过提供为期两天的癌症护理和沟通研讨会，为肿瘤科护士提供护士沟通培训。这一创新的教育计划将是第一个以护士为重点的培训计划，因为在过去十年中，这一领域的先前工作完全集中在医生的角色上。通过这项建议，我们希望建立一个受过沟通培训的护士网络，他们可以培训其他护士并发起机构改革。具体目标：该项目旨在为癌症护理调整既定的沟通培训课程。其次，该项目旨在将课程提供给来自NCI指定的癌症中心和社区癌症中心的竞争选定的肿瘤学护士团队。最后，该项目旨在评估课程的影响并传播结果，以发展一个在以病人为中心的沟通方面具有专业知识的护士网络。癌症教育计划：癌症教育计划将以舒适沟通课程为基础。Comfort是一个首字母缩写，代表护士沟通的七项基本原则，并向护士传授完成国家癌症研究所定义的以患者为中心的沟通的六项核心功能所需的技能。临床护士和肿瘤学教育领域的专家教师已经确认了他们的 参与，以及肿瘤学护理学会的支持。建议每年举办为期两天的课程，为期四年，培训100名护士，为全国400名肿瘤科护士提供培训。对拟议的癌症教育计划计划的评估将包括对课程内容、个人目标实现和机构绩效改进的评估。课程结束后，学员将确定制度变革的目标，6个月和12个月的跟踪将评估目标的实现、障碍和成功。这项建议支持NCI的战略目标，即通过将NCI以患者为中心的沟通框架转化为实用工具，使肿瘤科护士能够为癌症患者及其家人提供及时、高效和公平的护理，从而提高癌症患者、幸存者及其家人的生活质量。

DESCRIPTION (provided by applicant): Cancer patients and their family members continue to report communication deficits with their healthcare staff regarding diagnosis, disease progression, education about treatment and procedures, referral services, and psychosocial care. Given their increased exposure to patients and families, along with the intimacy of the care they provide, oncology nurses are often vulnerable to patient/family discussions about these topics. While national agendas and standard of care guidelines highlight the importance of communication during cancer care, nurses report being uncomfortable disclosing bad news, a lack of knowledge about cancer survivorship, difficulty discussing spiritual and sexual concerns, and experience missed opportunities to refer cancer patients to hospice. The proposed cancer education program will provide nurse communication training for oncology nurses by offering a two day workshop on cancer care and communication. This innovative educational initiative will be the first nurse-focused training program as prior work in this area over the last decade has focused exclusively on the role of the physician. Through this proposal we hope to establish a network of nurses trained in communication who can train other nurses and initiate institutional change. Specific Aims: The project aims to adapt an established communication training curriculum for cancer care. Secondly, the project aims to deliver the curriculum to competitively selected oncology nurse teams from NCI-designated cancer centers and community cancer centers. Finally, the project aims to evaluate the impact of the curriculum and disseminate findings to develop a network of nurses with expertise in patient-centered communication. Cancer Education Program Plan: The cancer education program plan will be based on the COMFORT communication curriculum. COMFORT is an acronym that stands for the seven basic principles of nurse communication and teaches nurses the skills they need to accomplish the six core functions of patient- centered communication as defined by the National Cancer Institute. Expert faculty in the area of clinical nurse and oncology education have confirmed their involvement, along with support from the Oncology Nursing Society. It is proposed that a two-day course be held annually for four years to 100 nurses, providing training to a total of 400 oncology nurses nationwide. Evaluation of the proposed cancer education program plan will include an assessment of curriculum content, individual goal achievement and institutional performance improvement. Upon completion of the course, participants will identify goals for institutional change and 6 and 12 month follow up will assess goal attainment, barriers, and successes. This proposal supports the NCI strategic aim of improving the quality of life for cancer patients, survivors, and their families by translating NCI's patient-centered communication framework into practical tools that will enable oncology nurses to provide timely, efficient, and equitable care to cancer patients and their families.