Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Pain Symptom Manage. 2013 Dec;46(6):785-94. doi: 10.1016/j.jpainsymman.2013.01.013. Epub 2013 Jun 10.
When a patient receives a cancer diagnosis, existential issues become more compelling. Throughout the illness trajectory, patients with cancer are cared for in oncology wards, by home care teams or in hospices. Nurses working with these patients are sometimes aware of the patients' existential needs but do not feel confident when discussing these issues.
To determine the effects of a training intervention, where the focus is on existential issues and nurses' perceived confidence in communication and their attitude toward caring for dying patients.
This was a randomized, controlled trial with a training intervention comprising theoretical training in existential issues combined with individual and group reflection. In total, 102 nurses in oncology and hospice wards and in palliative home care teams were randomized to a training or non-training group. Primary outcomes, confidence in communication, and attitude toward the care of dying patients were measured at baseline, immediately after the training, and five to six months later.
Confidence in communication improved significantly in the training group from baseline (before the training) to both the first and second follow-up, that is, immediately after the training and five months later. The attitude toward caring for the dying did not improve in the training group.
This study shows that short-term training with reflection improves the confidence of health care staff when communicating, which is important for health care managers with limited resources. Further studies are needed to explore how patients experience the communication skills of health care staff after such training.
当患者被诊断出患有癌症时,其存在问题就变得更加紧迫。在整个疾病过程中,癌症患者在肿瘤科病房、家庭护理团队或临终关怀机构中接受治疗。与这些患者一起工作的护士有时会意识到患者的存在需求,但在讨论这些问题时却缺乏信心。
确定一项培训干预措施的效果,该措施的重点是存在问题以及护士对沟通的感知信心、对照顾临终患者的态度。
这是一项随机对照试验,采用培训干预措施,包括存在问题的理论培训以及个人和小组反思。共有 102 名肿瘤科、临终关怀病房和姑息治疗家庭护理团队的护士被随机分配到培训组或非培训组。主要结局指标包括沟通信心和对临终患者护理的态度,在基线时、培训后立即以及 5 至 6 个月后进行测量。
培训组的沟通信心从基线(培训前)到第一次和第二次随访(培训后立即和 5 个月后)均显著提高。培训组对临终关怀的态度没有改善。
这项研究表明,短期培训和反思可以提高医护人员沟通的信心,这对资源有限的医疗保健管理人员来说非常重要。需要进一步研究患者在接受此类培训后如何体验医护人员的沟通技巧。