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癌症护理中的沟通技能培训:我们现状如何,又将走向何方?

Communication skills training in cancer care: where are we and where are we going?

作者信息

Merckaert Isabelle, Libert Yves, Razavi Darius

机构信息

Université Libre de Bruxelles, Belgium.

出版信息

Curr Opin Oncol. 2005 Jul;17(4):319-30. doi: 10.1097/01.cco.0000167737.72196.f9.

Abstract

PURPOSE OF REVIEW

This review gives an overview of recent developments in the field of communication skills training programs designed for cancer health care professionals.

RECENT FINDINGS

The Web of Knowledge was searched for empirical papers published between January 2002 and February 2005. Twenty-two papers were included in the review describing 13 different studies. Four studies were randomised trials using a pretest-posttest comparison design. As regards participant-based outcomes, studies showed improvements in terms of participant satisfaction with course, reported improvements in communication skills, increased knowledge and confidence, and changes in attitudes and beliefs. Results in terms of participants' level of stress and burnout were inconsistent across studies. Improvements were observed as regards the use of taught skills following training. Three studies using an utterance-by-utterance analysis system reported improvements in physicians' use of assessment skills or supportive skills. One study observed improvements in terms of decision-making skills. No change was observed as regards physicians' detection of patient distress. As regards patient-based outcomes, only two of four studies reported improvements in terms of patient satisfaction with and perception of interviews.

SUMMARY

Results of this review confirm the usefulness of learner-centred, skills-focused, and practise-oriented communication skills training programs organised in small groups of a maximum 6 participants and lasting at least 20 hours. Such communication skills training programs may therefore be recommended to health care professionals treating cancer patients and their families.

摘要

综述目的

本综述概述了为癌症医疗保健专业人员设计的沟通技能培训项目领域的最新进展。

近期研究结果

在知识网络中检索了2002年1月至2005年2月发表的实证研究论文。本综述纳入了22篇论文,描述了13项不同的研究。四项研究为采用前测-后测比较设计的随机试验。关于基于参与者的结果,研究表明参与者对课程的满意度有所提高,沟通技能有所改善,知识和信心增强,态度和信念也有所改变。各研究中参与者的压力和倦怠水平结果不一致。培训后观察到所学技能的使用有所改善。三项使用逐句分析系统的研究报告称,医生在使用评估技能或支持技能方面有所改进。一项研究观察到决策技能有所提高。未观察到医生对患者痛苦的察觉有变化。关于基于患者的结果,四项研究中只有两项报告称患者对访谈的满意度和看法有所改善。

总结

本综述结果证实了以学习者为中心、以技能为重点、以实践为导向的沟通技能培训项目的有用性,这些项目以每组最多6名参与者的小组形式组织,持续时间至少20小时。因此,这类沟通技能培训项目可推荐给治疗癌症患者及其家属的医疗保健专业人员。

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