Farrell Michael H, Speiser Jodi, Deuster Lindsay, Christopher Stephanie
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA.
Arch Pediatr Adolesc Med. 2012 Jan;166(1):62-7. doi: 10.1001/archpediatrics.2011.696.
To demonstrate a quantitative abstraction method for Communication Quality Assurance projects to assess physicians' communication about hidden emotions after newborn genetic screening.
Communication quality indicator analysis.
Standardized parent encounters performed in practicing physicians' clinics or during educational workshops for residents.
Fifty-nine pediatrics residents, 53 pediatricians, and 31 family physicians.
Participants were asked to counsel standardized parents about a screening result; counseling was recorded, transcribed, and parsed into statements (each with 1 subject and 1 predicate). Pairs of abstractors independently compared statements with a data dictionary containing explicit-criteria definitions.
Four groups of "precautionary empathy" behaviors (assessment of emotion, anticipation/validation of emotion, instruction about emotion, and caution about future emotion), with definitions developed for both "definite" and "partial" instances.
Only 38 of 143 transcripts (26.6%) met definite criteria for at least 1 of the precautionary empathy behaviors. When partial criteria were counted, this number increased to 80 of 143 transcripts (55.9%). The most common type of precautionary empathy was the "instruction about emotion" behavior (eg, "don't be worried"), which may sometimes be leading or premature.
Precautionary empathy behaviors were rare in this analysis. Further study is needed, but this study should raise concerns about the quality of communication services after newborn screening.
展示一种用于沟通质量保证项目的定量抽象方法，以评估医生在新生儿基因筛查后关于隐藏情绪的沟通情况。
沟通质量指标分析。
在执业医生诊所或住院医师教育工作坊中进行的标准化家长问诊。
59名儿科住院医师、53名儿科医生和31名家庭医生。
要求参与者就一项筛查结果为标准化家长提供咨询；咨询过程进行录音、转录，并解析为陈述语句（每个语句有1个主语和1个谓语）。成对的摘要撰写人独立地将陈述语句与包含明确标准定义的数据字典进行比较。
四组“预防性共情”行为（情绪评估、情绪预期/确认、情绪指导和对未来情绪的提醒），针对“明确”和“部分”情况都制定了定义。
143份记录稿中，只有38份（26.6%）至少在一种预防性共情行为上符合明确标准。若计入部分标准，则这一数字增至143份记录稿中的80份（55.9%）。最常见的预防性共情类型是“情绪指导”行为（例如，“别担心”），这种行为有时可能具有引导性或为时过早。
在本分析中，预防性共情行为很少见。需要进一步研究，但本研究应引发对新生儿筛查后沟通服务质量的关注。
