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基于患者在接收坏消息时对沟通的偏好的肿瘤学家沟通技巧培训方案的效果:一项随机对照试验。

Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial.

机构信息

Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

J Clin Oncol. 2014 Jul 10;32(20):2166-72. doi: 10.1200/JCO.2013.51.2756. Epub 2014 Jun 9.

Abstract

PURPOSE

The aim of this study was to identify the effects of a communication skills training (CST) program for oncologists, developed based on patient preferences regarding oncologists' communication.

PARTICIPANTS AND METHODS

Thirty oncologists were randomly assigned to either an intervention group (IG; 2-day CST workshop) or control group (CG). Participants were assessed on their communication performance during simulated consultation and their confidence in communicating with patients at baseline and follow-up. A total of 1,192 patients (response rate, 84.6%) who had consultations with the participating oncologists at baseline and/or follow-up were assessed regarding their distress using the Hospital Anxiety and Depression Scale, satisfaction with the consultation, and trust in their oncologist after the consultation.

RESULTS

At the follow-up survey, the performance scores of the IG had improved significantly, in terms of their emotional support (P = .011), setting up a supportive environment (P = .002), and ability to deliver information (P = .001), compared with those of the CG. Oncologists in the IG were rated higher at follow-up than those in the CG in terms of their confidence in themselves (P = .001). Patients who met with oncologists after they had undergone the CST were significantly less depressed than those who met with oncologists in the CG (P = .027). However, the CST program did not affect patient satisfaction with oncologists' style of communication.

CONCLUSION

A CST program based on patient preferences is effective for both oncologists and patients with cancer. Oncologists should consider CST as an approach to enhancing their communication skills.

摘要

目的

本研究旨在确定一种基于患者对肿瘤医生沟通偏好的沟通技巧培训(CST)计划对肿瘤医生的影响。

参与者和方法

30 名肿瘤医生被随机分配到干预组(IG;为期 2 天的 CST 研讨会)或对照组(CG)。在基线和随访时,通过模拟咨询评估参与者的沟通表现及其与患者沟通的信心。共有 1192 名患者(响应率为 84.6%)在基线和/或随访时与参加的肿瘤医生进行了咨询,使用医院焦虑和抑郁量表评估他们的痛苦、对咨询的满意度以及对肿瘤医生的信任。

结果

在随访调查中,IG 的表现评分在情感支持(P=0.011)、营造支持性环境(P=0.002)和传递信息能力(P=0.001)方面与 CG 相比有显著提高。与 CG 相比,IG 中的肿瘤医生在随访时对自己的信心评分更高(P=0.001)。接受 CST 后与肿瘤医生见面的患者比 CG 中与肿瘤医生见面的患者抑郁程度显著降低(P=0.027)。然而,CST 计划并没有影响患者对肿瘤医生沟通方式的满意度。

结论

基于患者偏好的 CST 计划对肿瘤医生和癌症患者都有效。肿瘤医生应考虑 CST 作为提高沟通技巧的一种方法。

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