Wittenberg Elaine, Goldsmith Joy, Ferrell Betty, Platt Christine Small
Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, California, USA.
Department of Communication, University of Memphis, Memphis Tennessee, USA.
J Pain Symptom Manage. 2015 Nov;50(5):707-11. doi: 10.1016/j.jpainsymman.2015.06.007. Epub 2015 Jul 7.
Symptom management is a key dimension of palliative care. In addition to aspects such as assessment and pharmacological management of symptoms, professionals also require communication skills to effectively manage symptoms in serious illness.
Application of the Plain Language Planner for Palliative Care(©), a provider tool for communicating about medication and symptoms using plain language, was tested.
Approximately 75% of the 155 health care professionals, mostly nurses, who participated in a before-and-after educational activity about the tool, provided written communication explanations using one of three medication-symptom pairs: senna for constipation, amitriptyline for nerve pain, and lorazepam for anxiety. Responses were coded for plain language characteristics: active voice, second person, use of jargon, brief sentences, reading level, and easy to understand data phrasing. Frequency counts for coding categories were calculated and compared across medication-symptom pairs before and after the education session.
A comparison between written responses before and after the education session showed improvement in the use of plain language. Overall, plain language scores were highest for communication about senna (81%), followed by amitriptyline (72%) and lorazepam (77%). Across all three medication-symptom pairs, the greatest improvement in the use of plain language occurred in the use of jargon.
Provider training with the tool produced increased plain language. Use of the tool in provider education shows promise in increasing the health literacy for patients and families regarding symptom management.
症状管理是姑息治疗的一个关键维度。除了症状评估和药物管理等方面外,专业人员还需要沟通技巧来有效管理重症患者的症状。
测试姑息治疗简明语言规划工具(©),这是一种使用简明语言就药物和症状进行沟通的医疗服务提供者工具。
155名医疗保健专业人员(大多数是护士)参与了关于该工具的前后教育活动,其中约75%的人员使用三对药物-症状组合之一提供了书面沟通解释:用番泻叶治疗便秘、用阿米替林治疗神经痛、用劳拉西泮治疗焦虑。对回复进行简明语言特征编码:主动语态、第二人称、行话使用、简短句子、阅读水平以及易于理解的数据表述。计算编码类别的频率计数,并在教育课程前后对三对药物-症状组合进行比较。
教育课程前后书面回复的比较显示,简明语言的使用有所改善。总体而言,关于番泻叶的沟通简明语言得分最高(81%),其次是阿米替林(72%)和劳拉西泮(77%)。在所有三对药物-症状组合中,简明语言使用方面最大的改善出现在行话的使用上。
使用该工具对医疗服务提供者进行培训可提高简明语言的使用。在医疗服务提供者教育中使用该工具有望提高患者及其家属在症状管理方面的健康素养。