Department of Communication, Texas A&M University, College Station, TX 77843-4234, USA.
Patient Educ Couns. 2010 Jul;80(1):42-7. doi: 10.1016/j.pec.2009.10.009. Epub 2009 Dec 4.
This study examined the effect of a theoretically grounded, tailored education-coaching intervention to help patients more effectively discuss their pain-related questions, concerns, and preferences with physicians.
Grounded in social-cognitive and communication theory, a tailored education-coaching (TEC) intervention was developed to help patients learn pain management and communication skills. In a RCT, 148 cancer patients agreed to have their consultations audio-recorded and were assigned to the intervention or a control group. The recordings were used to code for patients' questions, acts of assertiveness, and expressed concerns and to rate the quality of physicians' communication.
Patients in the TEC group discussed their pain concerns more than did patients in the control group. More active patients also had more baseline pain and interacted with physicians using participatory decision-making. Ratings of physicians' information about pain were higher when patients talked more about their pain concerns.
The study demonstrates the efficacy of a theoretically grounded, coaching intervention to help cancer patients talk about pain control.
Coaching interventions can be effective resources for helping cancer patients communicate about their pain concerns if they are theoretically grounded, can be integrated within clinical routines, and lead to improve health outcomes.
本研究旨在检验一种基于理论、量身定制的教育-辅导干预措施对帮助患者更有效地与医生讨论其疼痛相关问题、担忧和偏好的效果。
该量身定制的教育-辅导（TEC）干预措施基于社会认知和沟通理论制定，旨在帮助患者学习疼痛管理和沟通技巧。在一项 RCT 中，148 名癌症患者同意将其咨询过程进行录音，并被分配到干预组或对照组。录音用于对患者的问题、自信行为、表达的担忧进行编码，并对医生沟通质量进行评分。
与对照组相比，TEC 组的患者更多地讨论了他们的疼痛问题。更积极的患者也有更高的基线疼痛水平，并与医生一起使用参与式决策进行互动。当患者更多地谈论他们的疼痛问题时，他们对医生关于疼痛的信息评价更高。
该研究证明了一种基于理论、辅导干预措施在帮助癌症患者谈论疼痛控制方面的有效性。
如果辅导干预措施基于理论、可以融入临床常规、并能改善健康结果，那么它们可以成为帮助癌症患者沟通疼痛问题的有效资源。
