Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Brussels, Belgium.
Patient Educ Couns. 2011 Nov;85(2):180-7. doi: 10.1016/j.pec.2010.09.022. Epub 2010 Dec 4.
The aim of this study was to investigate residents' characteristics associated with their performance in detecting patients' distress (detection performance).
Residents' detection performance was assessed in a clinical round. A mean detection performance score was calculated for each resident by comparing residents' rating of patients' distress (VAS) with patients' reported distress (HADS). Residents' characteristics include general (socio-demographic, professional and psychological), detection (self-efficacy, attitudes and outcome expectancies) and performance characteristics (communication skills (LaComm), psychological arousal (STAI) and physiological arousal (heart rate and blood pressure) in a highly emotional and complex simulated interview task).
Ninety-four residents and 442 inpatients were included. 30% of the variance in residents' detection performance was related to residents' performance characteristics: anxiety level (p=.040) and mean arterial blood pressure (p=.019) before the task; empathy (p=.027) and mean heart rate (p=.043) during the task; mean arterial blood pressure changes (p=.012) during the assessment procedure.
Residents' detection performance is partly related to their performance characteristics. Psychological and physiological arousals are key characteristics--beside empathic skills--that need to be considered in models designed to determine detection performance.
Future interventions designed to improve residents' detection performance should focus notably on their performance characteristics.
本研究旨在探讨与居民察觉患者痛苦（察觉表现）相关的特征。
通过比较居民对患者痛苦的评估（VAS）与患者报告的痛苦（HADS），评估居民的察觉表现。居民的特征包括一般特征（社会人口统计学、专业和心理）、察觉特征（自我效能、态度和结果预期）和表现特征（在高度情绪化和复杂的模拟访谈任务中，沟通技巧（LaComm）、心理唤醒（STAI）和生理唤醒（心率和血压））。
纳入了 94 名居民和 442 名住院患者。居民察觉表现的 30%差异与居民的表现特征有关：任务前的焦虑水平（p=.040）和平均动脉血压（p=.019）；任务期间的同理心（p=.027）和平均心率（p=.043）；评估过程中的平均动脉血压变化（p=.012）。
居民的察觉表现部分与他们的表现特征有关。心理和生理唤醒是需要在设计用于确定察觉表现的模型中考虑的关键特征——除了同理心技能之外。
未来旨在提高居民察觉表现的干预措施应特别关注他们的表现特征。
