Thomas Veronica J, Cohn Tom
Consultant Health Psychologist, Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
J Adv Nurs. 2006 Feb;53(4):480-8. doi: 10.1111/j.1365-2648.2006.03741.x.
This paper reports a project evaluating the efficacy and impact of a pilot communication skills and cultural awareness course for healthcare professionals who care for patients with sickle cell disease.
Poor communication between patients with sickle cell disease and healthcare professionals causes suspicion and mistrust. Many patients feel that they are negatively labelled by the healthcare system and are sceptical of opening themselves to an unsympathetic system. They may therefore appear hostile and aggressive when interacting with healthcare professionals, which in turn leads to distortions and misunderstandings between both groups. The use of good communication skills by healthcare professionals is therefore vital for good healthcare practice.
Forty-seven healthcare professionals took part in a series of three pilot courses each lasting 3 days. Healthcare professionals were taught a repertoire of communication skills and cultural awareness strategies to use in challenging situations that arise in their care of sickle cell patients. Expert facilitators used a variety of teaching techniques, such as professionally-made videos, role-play, and group exercises. Participants' confidence in dealing with challenging situations was assessed at baseline, immediately after the intervention, and at 3- and 6-month postintervention.
A repeated measures anova revealed a statistically significant increase in confidence from pre- to postcourse scores. Confidence scores further increased from immediately postcourse and 3 months postcourse follow-up. These were then maintained at 6 months postcourse.
The overall findings of this local study demonstrated that this type of communication skills and cultural awareness training had a positive and enduring impact on professionals' perceived ability and confidence in communicating with patients with sickle cell disease. Participants attributed this to the learner-centred approach of the course that provided them with the opportunity to transfer and apply the taught skills in their daily practice. This type of training might be helpful in reducing mistrust and increasing empathetic responses in healthcare professional.
本文报告了一个项目,该项目评估了为照顾镰状细胞病患者的医护人员开设的沟通技巧与文化意识试点课程的效果和影响。
镰状细胞病患者与医护人员之间沟通不畅会导致猜疑和不信任。许多患者觉得自己被医疗系统负面标签化,并且对向一个冷漠的系统敞开心扉持怀疑态度。因此,他们在与医护人员互动时可能会显得敌意和攻击性,这反过来又导致双方之间的曲解和误解。所以,医护人员运用良好的沟通技巧对于良好的医疗实践至关重要。
47名医护人员参加了一系列为期3天的三门试点课程。向医护人员传授了一系列沟通技巧和文化意识策略,以便在他们照顾镰状细胞病患者时出现的具有挑战性的情况下使用。专家主持人采用了多种教学技巧,如专业制作的视频、角色扮演和小组练习。在基线、干预后即刻、干预后3个月和6个月时评估参与者应对具有挑战性情况的信心。
重复测量方差分析显示,课程前后的信心得分在统计学上有显著提高。信心得分在课程结束后即刻和课程结束后3个月的随访中进一步提高。然后在课程结束后6个月保持稳定。
这项本地研究的总体结果表明,这种沟通技巧和文化意识培训对专业人员与镰状细胞病患者沟通的感知能力和信心产生了积极且持久的影响。参与者将此归因于课程以学习者为中心的方法,该方法为他们提供了在日常实践中转移和应用所学技能的机会。这种培训可能有助于减少医疗专业人员中的不信任并增加共情反应。