Reducing Health Disparities at End of Life

描述（由申请人提供）：本项目将扩大互动式、基于网络的培训材料，旨在提高临床医生与不同人群患者之间沟通的有效性，从而提高生命末期医疗保健的质量。本研究的目的是描述基于网络的文化和临终关怀项目对以下方面的影响：患者对沟通质量的评分、患者的焦虑和对临床医生的信任。此外，临床医生与患者交流的内容编码将被评估，文化能力评分将由临床医生自行评估。我们的跨学科研究团队将招募40名初级保健临床医生，每位临床医生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。患者将完成问卷，评估临床医生在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音。本研究将激发探索性和发展性研究，以解决当前卫生保健系统中有记录的需求：加强文化上一致的临终沟通。公共卫生相关性：该项目将扩大互动式网络培训材料，旨在提高临床医生与不同人群患者之间沟通的有效性，从而提高生命末期保健的质量。该项目将评估基于网络的初级卫生临床医生培训对患者评估的临终沟通质量的影响，并采用基于内容的临床医生与患者沟通编码。

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.