The effect of a communication skills training based on coaching method for physician specializing in stroke

本研究的目的如下：1)开发低要求、高精度的患者报告结果测量方法；2)开发基于教练策略的脑卒中专科医生医疗沟通技巧培训课程；3)研究MCST对患者满意度和生活质量的影响。这项研究的参与者是34名治疗中风幸存者的医生。他们接受为期两天的MCST，该MCST结合了讲座和角色扮演练习，并在MCST学习后的两个月内通过电子邮件接收主题。医生参与者要求他们的中风患者和家庭护理人员在MCST前、MCST后一个月、五个月和十个月完成问卷。患者问卷包括与医生沟通的满意度（沟通满意度、总满意度和朝着目标行动）和与健康相关的生活质量（SF-36）。家庭照护者报告其照护负担（The burden Index of Caregiving: BIC11）。医生们对自己的沟通技巧进行了评估。完成所有问卷调查的参与者有23名医生（平均年龄42.0岁，SD 8.2）， 73名患者（平均年龄63.6岁，SD 10.1）。MCST前后医师自我评价得分变化无统计学意义。沟通满意度（MCST前vs术后；46.8±7.1 vs 48.6±6.3 [p<0.001]）、总满意度（16.8±2.3 vs 17.4±2.3 [p<0.001]）和行动目标（14.6±3.1 vs 15.2±3.0 [p<0.05]）均显著提高。SF-36和BIC11评分无明显变化。本研究发现，医师的MCST可以提高患者的满意度，促进患者向目标迈进。

The aims of this study were as follows; 1) to develop the less demanding and high-precision measurement methodology of patient-reported outcomes, 2) to develop the curriculum of medical communication skill training (MCST) for stroke specialist based on coaching strategy, and 3) to examine the effectiveness of MCST on the satisfaction and quality of life of patients. The participants of this study were 34 physicians who charged stroke survivors. They received two day MCST which combined lecture and role-playing exercise and received the topics by the e-mail for 2 months after MCST study.Physician participants asked their patients with stroke and family caregivers to complete the questionnaire before the MCST, one month, five months and ten months after the MCST. The questionnaire for patients involved the measures of satisfaction with communication to their doctor (satisfaction with communication, total satisfaction, and act toward the goal) and health-related quality of life (the SF-36). The family caregivers reported their burden of care giving (The Burden Index of Caregiving: BIC11). The physicians evaluated themselves concerning their communication skills.The participants who complete all questionnaires were 23 physicians (mean age, 42.0; SD, 8.2), 73 patients (mean age, 63.6; SD, 10.1). The change score of physician's self evaluation between before and after the MCST were not significant. The satisfaction with communication (before MCST vs after MCST; 46.8 ± 7.1 vs 48.6 ± 6.3 [p<0.001]), the total satisfaction (16.8 ± 2.3 vs 17.4 ± 2.3 [p<0.001]) and act toward the goal (14.6 ± 3.1 vs 15.2 ± 3.0 [p<0.05]) were improved significantly. The score of the SF-36 and BIC11 did not significantly change.This study has found that the MCST for physicians can improve the patient's satisfaction and facilitate them toward the goal.