Butow Phyllis, Cockburn Jill, Girgis Afaf, Bowman Deborah, Schofield Penelope, D'Este Catherine, Stojanovski Elizabeth, Tattersall Martin H N
Medical Psychology Research Unit, School of Psychology, Brenan/McCallum Building, [A18], University of Sydney, Camperdown, NSW 2006, Australia.
Psychooncology. 2008 Mar;17(3):209-18. doi: 10.1002/pon.1217.
Psychological morbidity in cancer patients is common, but often undetected and untreated. We developed a communication skills training (CST) program targeting this issue, and evaluated its impact on doctor behaviour.
Thirty of 35 oncologists from six teaching hospitals in six Australian cities, participated. The CST was a 1.5-day intensive face-to-face workshop incorporating presentation of principles, a DVD modelling ideal behaviour and role-play practice, followed by four 1.5 h monthly video-conferences incorporating role-play of doctor-generated scenarios. Doctors were randomized to receive the CST or not. Simulated patient interviews were videotaped and coded at baseline, after CST and 6 months later. Doctors completed questionnaires assessing stress and burnout at the same time points.
Doctors in the intervention group displayed more creating environment and fewer blocking behaviours at both follow-ups; however, these differences did not reach statistical significance. Intervention doctors valued the training highly, but did not report substantial reductions in stress and burnout.
This short training programme demonstrated a positive effect on aspects of doctor behaviour. Video-conferencing after a short training course may be an effective strategy for delivering CST.
癌症患者的心理问题很常见，但往往未被发现和治疗。我们针对这一问题开发了一种沟通技巧培训（CST）项目，并评估其对医生行为的影响。
来自澳大利亚六个城市六家教学医院的35名肿瘤学家中有30人参与。CST是一个为期1.5天的强化面对面研讨会，包括原则讲解、一段展示理想行为的DVD以及角色扮演练习，随后是四个每月一次的1.5小时视频会议，内容为医生提出场景的角色扮演。医生被随机分为接受CST组和非接受CST组。在基线、CST后以及6个月后对模拟患者访谈进行录像并编码。医生在相同时间点完成评估压力和职业倦怠的问卷。
干预组医生在两次随访中表现出更多营造环境行为和更少阻碍行为；然而，这些差异未达到统计学显著性。接受干预的医生对培训评价很高，但并未报告压力和职业倦怠有大幅降低。
这个简短的培训项目对医生行为的某些方面显示出积极影响。短期培训课程后的视频会议可能是提供CST的有效策略。
