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改善医患沟通:对纽约州妇女、婴儿和儿童(WIC)专业人员培训项目的评估。

Improving client-provider communication: evaluation of a training program for women, infants and children (WIC) professionals in New York state.

作者信息

Newes-Adeyi Gabriella, Helitzer Deborah L, Roter Debra, Caulfield Laura E

机构信息

CSR, Incorporated, 2107 Wilson Boulevard, Suite 1000, Arlington, VA 22201, USA.

出版信息

Patient Educ Couns. 2004 Nov;55(2):210-7. doi: 10.1016/j.pec.2003.05.001.

Abstract

Results are presented from evaluation of an intensive 1 day training program to improve the growth monitoring counseling skills of Special Supplemental Nutrition Program for Women, Infants and Children (WIC) providers. The training was framed by the patient-centered approach, and focused on a seven-step technique that emphasized eliciting client perspective on the child's health and negotiating follow-up strategies. Changes in skill were assessed during audiotaped mock counseling sessions with simulated clients. Observed intervention effects were moderate but encouraging for future training programs. After the training, more providers elicited client perspective, and provider level of engagement in negotiating with the client increased. At post-test providers asked more open-ended questions than at pre-test, and provider-to-client talk ratio decreased. Increases in provider total and competence-related satisfaction paralleled improvements in counseling proficiency. Study results suggest that counseling skills of non-physician health providers can change after a 1 day focused training: providers were more client-centered in their discussions. Limitations and implications of the study are discussed.

摘要

本文呈现了对一项为期1天的强化培训项目的评估结果,该项目旨在提高妇女、婴儿和儿童特殊补充营养项目(WIC)提供者的生长监测咨询技能。培训以患者为中心的方法为框架,重点关注一种七步法技术,该技术强调引导客户对儿童健康发表看法并协商后续策略。在与模拟客户进行的录音模拟咨询环节中评估技能变化。观察到的干预效果适中,但对未来的培训项目具有鼓舞作用。培训后,更多的提供者引导客户发表看法,并且提供者在与客户协商时的参与度有所提高。在测试后,提供者比测试前提出了更多开放式问题,并且提供者与客户的谈话比例下降。提供者总体满意度和与能力相关的满意度的提高与咨询熟练度的提高同步。研究结果表明,非医生健康提供者的咨询技能在经过为期1天的集中培训后可以发生变化:提供者在讨论中更以客户为中心。文中还讨论了该研究的局限性和意义。

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