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一项105小时心理培训计划对肿瘤学中态度、沟通技巧和职业压力的影响:一项随机研究。

Effects of a 105 hours psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study.

作者信息

Delvaux N, Razavi D, Marchal S, Brédart A, Farvacques C, Slachmuylder J-L

机构信息

Service de Psychologie, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, Bruxelles 1070, Belgium.

出版信息

Br J Cancer. 2004 Jan 12;90(1):106-14. doi: 10.1038/sj.bjc.6601459.

Abstract

There is today a wide consensus regarding the need to improve communication skills (CS) of health-care professionals (HCPs) dealing with cancer patients. Psychological training programs (PTPs) may be useful to acquire the needed CS. Testing the efficacy of PTP will allow to define their optimal content. The present study was designed to assess the impact of a PTP on HCP stress, attitudes and CS, and on HCP and patients' satisfaction with HCP communication skills in a randomised study. A total of 115 oncology nurses were randomly assigned to a 105-h PTP or to a waiting list. Stress was assessed with the Nursing Stress Scale, attitudes with a Semantic Differential Questionnaire, CS used during one simulated and one actual patient interview with the Cancer Research Campaign Workshop Evaluation Manual, and satisfaction with the nurses' CS with a questionnaire completed by the patients and the nurses. Trained (TG) and control (CG) groups were compared at baseline, after 3 months (just following training for TG) and after 6 months (3 months after the end of training for TG). Compared to controls, trained nurses reported positive changes on their stress levels (P</=0.05) and on their attitudes (P</=0.05). Positive training effects were found on CS used during the simulated interview: a significant increase in facilitative behaviours (open questions: P</=0.001; evaluative functions: P</=0.05) and a significant decrease in inhibitory behaviours (inappropriate information: P</=0.01; false reassurance: P</=0.05). Less positive training effects were found regarding interviews with a cancer patient: a significant increase in educated guesses (P</=0.001) was noticed. No training effect was observed on nurses' satisfaction levels, but a positive training effect was found on patients' satisfaction levels (P</=0.01). Although results outline PTP efficacy, they indicate the need to design PTP, amplifying the transfer of learned CS to clinical practice.

摘要

如今,人们对于提高医护人员(HCPs)与癌症患者沟通的沟通技巧(CS)的必要性已达成广泛共识。心理培训项目(PTPs)可能有助于获得所需的沟通技巧。测试心理培训项目的效果将有助于确定其最佳内容。本研究旨在通过一项随机研究评估心理培训项目对医护人员压力、态度和沟通技巧的影响,以及对医护人员和患者对医护人员沟通技巧满意度的影响。总共115名肿瘤护士被随机分配到一个105小时的心理培训项目组或等待名单组。使用护理压力量表评估压力,使用语义差异问卷评估态度,使用癌症研究运动工作坊评估手册对一次模拟和一次实际患者访谈中使用的沟通技巧进行评估,通过患者和护士填写的问卷评估对护士沟通技巧的满意度。在基线、3个月后(仅在培训组培训后)和6个月后(培训组培训结束3个月后)对培训组(TG)和对照组(CG)进行比较。与对照组相比,接受培训的护士报告其压力水平(P≤0.05)和态度(P≤0.05)有积极变化。在模拟访谈中使用的沟通技巧方面发现了积极的培训效果:促进性行为显著增加(开放式问题:P≤0.001;评估功能:P≤0.05),抑制性行为显著减少(不适当信息:P≤0.01;虚假安慰:P≤0.05)。在与癌症患者的访谈方面发现的积极培训效果较少:注意到有根据的猜测显著增加(P≤0.001)。未观察到对护士满意度水平的培训效果,但对患者满意度水平发现了积极的培训效果(P≤0.01)。虽然结果概述了心理培训项目的效果,但它们表明需要设计心理培训项目,加强所学沟通技巧向临床实践的转化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cca/2395320/cfbb7e1cc78d/90-6601459f1.jpg

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