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通过沟通辅导教授动机性访谈对初级保健和专注于儿科肥胖症的诊所中临床医生和患者满意度的影响。

Effect of teaching motivational interviewing via communication coaching on clinician and patient satisfaction in primary care and pediatric obesity-focused offices.

作者信息

Pollak Kathryn I, Nagy Paul, Bigger John, Bilheimer Alicia, Lyna Pauline, Gao Xiaomei, Lancaster Michael, Watkins R Chip, Johnson Fred, Batish Sanjay, Skelton Joseph A, Armstrong Sarah

机构信息

Cancer Control and Populations Sciences, Duke Cancer Institute, Durham, USA; Department of Community and Family Medicine, Duke School of Medicine, Durham, USA.

Department of Psychiatry, Duke School of Medicine, Durham, USA.

出版信息

Patient Educ Couns. 2016 Feb;99(2):300-3. doi: 10.1016/j.pec.2015.08.013. Epub 2015 Aug 11.

Abstract

OBJECTIVE

Studies indicate needed improvement in clinician communication and patient satisfaction. Motivational interviewing (MI) helps promote patient behavior change and improves satisfaction. In this pilot study, we tested a coaching intervention to teach MI to all clinic staff to improve clinician and patient satisfaction.

METHODS

We included four clinics (n=29 staff members). In the intervention clinics (one primary care and one pediatric obesity-focused), we trained all clinic staff in MI through meetings as a group seven times, directly observing clinicians in practice 4-10 times, and providing real-time feedback on MI techniques. In all clinics, we assessed patient satisfaction via anonymous surveys and also assessed clinician burnout and self-rated MI skills.

RESULTS

Clinicians in the intervention clinics reported improvements in burnout scores, self-rated MI skills, and perceived cohesion whereas clinicians in the control clinic reported worse scores. Patient satisfaction improved in the intervention clinics more than in the control clinics.

CONCLUSION

This is the first study to find some benefit of training an entire clinic staff in MI via a coaching model.

PRACTICE IMPLICATIONS

It might help to train staff in MI to improve clinician satisfaction, team cohesion, perceived skills, and patient satisfaction.

摘要

目的

研究表明临床医生沟通及患者满意度有待提高。动机性访谈(MI)有助于促进患者行为改变并提高满意度。在这项试点研究中,我们测试了一种指导干预措施,向所有诊所工作人员传授动机性访谈,以提高临床医生和患者的满意度。

方法

我们纳入了四家诊所(共29名工作人员)。在干预诊所(一家初级保健诊所和一家专注于儿童肥胖症的诊所),我们通过七次集体会议对所有诊所工作人员进行动机性访谈培训,对临床医生的实际操作进行4至10次直接观察,并就动机性访谈技巧提供实时反馈。在所有诊所,我们通过匿名调查评估患者满意度,同时评估临床医生的职业倦怠和自我评估的动机性访谈技能。

结果

干预诊所的临床医生报告职业倦怠得分、自我评估的动机性访谈技能及团队凝聚力有所改善,而对照诊所的临床医生报告得分更差。干预诊所的患者满意度提高幅度大于对照诊所。

结论

这是第一项发现通过指导模式对整个诊所工作人员进行动机性访谈培训有一定益处的研究。

实践意义

对工作人员进行动机性访谈培训可能有助于提高临床医生满意度、团队凝聚力、感知技能及患者满意度。

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