Salisbury NHS Foundation Trust, Salisbury District Hospital, Salisbury, Wiltshire, United Kingdom.
Palliat Support Care. 2010 Mar;8(1):27-33. doi: 10.1017/S1478951509990678. Epub 2010 Feb 18.
In the United Kingdom, a Four-Tier Model of Psychological Support has been recommended for all patients with cancer and their families. This model suggests that staff at Tier 2, such as nurses, doctors, and allied health professionals, should be proficient in screening for psychological distress and intervening with techniques such as psycho-education and problem solving. Research has suggested that although communication skills training is essential for staff working in cancer services, it does not necessarily improve the detection of specific psychological disorder or staff confidence in intervening with highly distressed patients. The objective was therefore to design a training program that addressed this deficit and was easily accessible to hospital staff.
A training package was developed to train staff in the recommended skills. A literature review of teaching modalities and the effectiveness of different formats was conducted. A four-session program was developed, to be administered by staff at Tiers 3 and 4 of the model, such as clinical psychologists and counsellors.
Over 3 years, 255 sets of data were collected from staff who attended the course. Precourse, postcourse, and 6-month follow-up data were collected through the use of confidence questionnaires, developed from the literature. The data show a significant improvement in staff confidence across all domains measured, including confidence in the detection and management of psychological distress (p =.0001).
Although the results have limitations and the data are subjective, we can conclude that this course significantly improves staff confidence in dealing with psychological distress and that this increased confidence is maintained over a 6-month follow-up period.
在英国，建议为所有癌症患者及其家属提供四级心理支持模型。该模型表明，二级医护人员（如护士、医生和联合健康专业人员）应熟练掌握心理困扰筛查，并采用心理教育和解决问题等技术进行干预。研究表明，尽管癌症服务机构工作人员的沟通技巧培训至关重要，但这并不一定能提高对特定心理障碍的检测能力，或提高工作人员对高度困扰患者进行干预的信心。因此，本研究旨在设计一种培训方案，以弥补这一缺陷，并使医院工作人员易于接受。
开发了一套培训包，用于培训工作人员掌握推荐的技能。对教学模式和不同格式的有效性进行了文献回顾。制定了一个四节课程，由模型的三级和四级医护人员（如临床心理学家和顾问）实施。
3 年来，共收集了 255 套参加课程的工作人员数据。通过使用从文献中开发的信心问卷，在课前、课后和 6 个月随访时收集数据。数据显示，工作人员在所有测量领域的信心均显著提高，包括对心理困扰的检测和管理的信心（p =.0001）。
尽管结果存在局限性且数据具有主观性，但我们可以得出结论，该课程显著提高了工作人员处理心理困扰的信心，并且这种信心在 6 个月的随访期间得以维持。
