Department of Family and Community Medicine, Damascus University, Damascus, Syria.
BMJ Open. 2013 Aug 14;3(8):e002674. doi: 10.1136/bmjopen-2013-002674.
To determine the effect of training residents in interpersonal and communication skills on women's satisfaction with doctor-woman relationship in labour and delivery rooms.
A stepped wedge cluster randomised trial.
4 tertiary care teaching maternity hospitals in Damascus, Syria.
2000 women who gave birth to a living baby in the four study hospitals and consented to participate in the intervention took part in the study. Women with difficult labour and high-risk pregnancies were excluded. All were interviewed at home after discharge.
A specially designed training package in communication skills was delivered to all resident doctors at the four hospitals.
The main outcome measure was women's satisfaction with interpersonal relationships in labour and delivery rooms measured via a series of questions on a Likert scale modified from the Medical Interview Satisfaction Scale.
At the individual level, the mean for the average satisfaction score was 3.23 (SD 0.72) of a possible score of 5 in the control group and 3.42 (SD 0.73) in the intervention group. Using generalised linear mixed models, we were unable to detect a difference between the mean for the average satisfaction score of women in the intervention arm and that of women in the control arm; the 95% CI associated with the effect of the intervention ranged from -0.08 to 0.15.
Despite slight changes in the observed residents' communication skills, the training package in communication skills does not seem to be associated with higher satisfaction scores of women. This raises the question of whether training individuals without further structural changes in the delivery of care and without further reinforcement of the training can have an impact on improving the quality of doctor-patient communication.
ISRCTN80243969.
评估培训住院医师人际沟通技能对产房医患关系中女性满意度的影响。
递进式楔形集群随机对照试验。
叙利亚大马士革 4 家三级教学妇产医院。
2000 名在 4 家研究医院分娩活产婴儿并同意参与干预的女性。排除难产和高危妊娠的女性。所有女性出院后在家中接受访谈。
在 4 家医院为所有住院医师提供专门设计的沟通技能培训包。
主要结局指标是通过对修改自医疗面谈满意度量表的一系列问题进行李克特量表评分来衡量女性对产房人际互动的满意度。
在个体水平上，对照组平均满意度评分为 3.23（SD 0.72），得分为 5 分制；干预组平均满意度评分为 3.42（SD 0.73）。使用广义线性混合模型，我们无法检测到干预组女性的平均满意度评分与对照组女性的平均满意度评分之间存在差异；干预效应的 95%CI 范围为-0.08 至 0.15。
尽管观察到住院医师沟通技能略有改善，但沟通技能培训包似乎并未与女性满意度评分的提高相关。这引发了一个问题，即是否培训个体而不进一步改变护理提供方式，且不进一步加强培训，是否能够对改善医患沟通质量产生影响。
ISRCTN80243969。
