Université Libre de Bruxelles, Brussels, Belgium.
Patient Educ Couns. 2013 Oct;93(1):40-7. doi: 10.1016/j.pec.2013.04.020. Epub 2013 May 29.
Breaking bad news (BBN) is a complex task which involves dealing cognitively with different relevant dimensions and a challenging task which involves dealing with intense emotional contents. No study however has yet assessed in a randomized controlled trial design the effect of a communication skills training on residents' physiological arousal during a BBN task.
Residents' physiological arousal was measured, in a randomized controlled trial design, by heart rate and salivary cortisol before, during and after a BBN simulated task.
Ninety-eight residents were included. MANOVA showed significant group-by-time effects. Trained residents' mean heart rate levels remained elevated after training and cortisol areas under the curve increased after training compared to untrained residents.
Communication skills training has an effect on residents' physiological arousal. Residents' self-efficacy and communication skills improvements in a BBN simulated task are associated with an elevated physiological arousal, which becomes proportional to the complexity of the task and reflects a better engagement and performance.
Residents should be informed that, to perform a task, they need to engage in the task with a physiological arousal proportional to the complexity of this task. Communication skills training should be adapted.
告知坏消息（BBN）是一项复杂的任务，涉及认知处理不同相关维度，也是一项具有挑战性的任务，涉及处理强烈的情绪内容。然而，迄今为止，尚无研究在随机对照试验设计中评估沟通技巧培训对居民在 BBN 任务期间生理唤醒的影响。
采用随机对照试验设计，通过心率和唾液皮质醇在 BBN 模拟任务之前、期间和之后测量居民的生理唤醒。
共纳入 98 名居民。MANOVA 显示出显著的组间时间效应。与未经培训的居民相比，经过培训的居民的平均心率水平在培训后仍然升高，皮质醇曲线下面积在培训后增加。
沟通技巧培训对居民的生理唤醒有影响。在 BBN 模拟任务中，居民的自我效能感和沟通技巧的提高与生理唤醒的提高有关，这种提高与任务的复杂性成正比，并反映了更好的参与度和表现。
应告知居民，为了完成任务，他们需要以与任务复杂性成比例的生理唤醒来参与任务。应调整沟通技巧培训。
