MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, UK.
Health Soc Care Community. 2012 Jul;20(4):430-7. doi: 10.1111/j.1365-2524.2012.01063.x. Epub 2012 Mar 27.
Effective communication is necessary for good relationships between healthcare practitioners and clients. This study examined barriers and facilitators to implementing new communication skills. One hundred and ten Sure Start Children's Centre staff attended one of 13 follow-up workshops in Southampton, UK between May 2009 and February 2011 to reflect on the use of new skills following a training course in communication, reflection and problem-solving. Barriers and facilitators were assessed with an adapted Problematic Experiences of Therapy scale (PETS). Staff reported frequency of skill use, and described what made it more difficult or easier to use the skills. Complete data were available for 101 trainees. The PETS indicated that staff had confidence in using the skills, but felt that there were practical barriers to using them, such as lack of time. Skills were used less often when staff perceived parents not to be engaging with them (Spearman's correlation r(s) = -0.42, P < 0.001), when staff felt less confident to use the skills (r(s) = -0.37, P < 0.001) and when there were more practical barriers (r(s) = -0.37, P < 0.001). In support of findings from the PETS, content analysis of free text responses suggested that the main barrier was a perceived lack of time to implement new skills. Facilitators included seeing the benefits of using the skills, finding opportunities and having good relationships with parents. Understanding the range of barriers and facilitators to implementation is essential when developing training to facilitate ongoing support and sustain skill use. Special attention should be given to exploring trainees' perceptions of time, to be able to address this significant barrier to skill implementation. Staff training requires a multi-faceted approach to address the range of perceived barriers.
有效的沟通对于医疗保健从业者和客户之间良好的关系是必要的。本研究考察了实施新沟通技巧的障碍和促进因素。2009 年 5 月至 2011 年 2 月期间，英国南安普敦的 110 名 Sure Start 儿童中心工作人员参加了 13 次后续研讨会之一，以反思在沟通、反思和解决问题培训课程后使用新技能。使用经过改编的治疗问题体验量表（PETS）评估障碍和促进因素。工作人员报告了技能的使用频率，并描述了使用技能更困难或更容易的原因。101 名受训人员中有完整数据。PETS 表明，工作人员对使用技能有信心，但认为在实际中使用这些技能存在障碍，例如缺乏时间。当工作人员认为家长不参与时（Spearman 相关系数 r(s)=-0.42，P<0.001），当工作人员对使用技能的信心较低时（r(s)=-0.37，P<0.001），当实际障碍较多时（r(s)=-0.37，P<0.001），技能的使用频率较低。支持 PETS 的发现，对自由文本回复的内容分析表明，主要障碍是实施新技能的时间不足。促进因素包括看到使用技能的好处，寻找机会以及与家长建立良好的关系。了解实施的障碍和促进因素的范围对于制定培训以促进持续支持和维持技能使用至关重要。特别应该关注探索学员对时间的看法，以便能够解决这一技能实施的重大障碍。员工培训需要采取多方面的方法来解决各种感知到的障碍。
