Lienard Aurore, Merckaert Isabelle, Libert Yves, Delvaux Nicole, Marchal Serge, Boniver Jacques, Etienne Anne-Marie, Klastersky Jean, Reynaert Christine, Scalliet Pierre, Slachmuylder Jean-Louis, Razavi Darius
Unité de Recherche en Psychosomatique et Psycho-oncologie, Université Libre de Bruxelles, Bruxelles, Belgium.
Psychooncology. 2008 May;17(5):488-96. doi: 10.1002/pon.1262.
No study has yet assessed the impact of physicians' skills acquisition after a communication skills training program on changes in patients' and relatives' anxiety following a three-person medical consultation. This study aimed at comparing, in a randomized study, the impact, on patients' and relatives' anxiety, of a basic communication skills training program and the same program consolidated by consolidation workshops and at investigating physicians' communication variables associated with patients' and relatives' anxiety.
Consultations with a cancer patient and a relative were recorded and analyzed by the Cancer Research Campaign Workshop Evaluation Manual. Patients' and relatives' anxiety were assessed with the State-Trait Anxiety Inventory-State.
No statistically significant change over time and between groups was observed. Mixed-effects modeling of changes in patients' and relatives' anxiety showed that decreases in both patients' and relatives' anxiety were linked with patients' and relatives' self-reported distress (p = 0.031 and 0.005), and that increases in both patients' and relatives' anxiety were linked with physicians' breaking bad news (p = 0.028 and 0.005).
No impact of the training program was observed. Results indicate the need to further study communication skills which may help reduce patients' and relatives' anxiety especially when breaking bad news.
尚无研究评估沟通技能培训项目后医生技能习得对三人医疗会诊后患者及亲属焦虑变化的影响。本研究旨在通过一项随机研究，比较基础沟通技能培训项目以及通过强化工作坊强化后的同一项目对患者及亲属焦虑的影响，并调查与患者及亲属焦虑相关的医生沟通变量。
使用癌症研究运动工作坊评估手册对癌症患者及其亲属的会诊进行记录和分析。采用状态-特质焦虑量表-状态评估患者及亲属的焦虑程度。
未观察到随时间及组间的统计学显著变化。患者及亲属焦虑变化的混合效应模型显示，患者及亲属焦虑程度的降低与患者及亲属自我报告的痛苦相关（p = 0.031和0.005），而患者及亲属焦虑程度的增加与医生告知坏消息有关（p = 0.028和0.005）。
未观察到培训项目的影响。结果表明需要进一步研究有助于减轻患者及亲属焦虑的沟通技能，尤其是在告知坏消息时。
