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沟通培训可改善以患者为中心的医疗服务行为,并促进对士兵心理健康问题的筛查。

Communication training improves patient-centered provider behavior and screening for soldiers' mental health concerns.

作者信息

Douglas Susan R, Vides de Andrade Ana Regina, Boyd Stephanie, Leslie Melanie, Webb Lynn, Davis Lauren, Fraine Melissa, Frazer Nicole L, Hargraves Ryan, Bickman Leonard

机构信息

Vanderbilt University, Nashville, TN, USA.

Vanderbilt University, Nashville, TN, USA.

出版信息

Patient Educ Couns. 2016 Jul;99(7):1203-1212. doi: 10.1016/j.pec.2016.01.018. Epub 2016 Jan 28.

Abstract

OBJECTIVE

To evaluate the effectiveness of patient-centered communication training for military providers who conduct post-deployment health screening. The half-day interactive workshop included simulated Soldier patients using video technology.

METHODS

Using a quasi-experimental design, all health care providers at four military treatment facilities were recruited for data collection during a four- to nine-day site visit (23 trained providers, 28 providers in the control group, and one provider declined to participate). All Soldiers were eligible to participate and were blinded to provider training status. Immediately after screening encounters, providers reported on their identification of mental health concerns and Soldiers reported on provider communication behaviors resulting in 1,400 matched pairs. Electronic health records were also available for 26,005 Soldiers.

RESULTS

The workshop was found to increase (1) providers' patient-centered communication behaviors as evaluated by Soldiers; (2) provider identification of Soldier mental health concerns; and (3), related health outcomes including provision of education and referral to a confidential counseling resource.

CONCLUSION

Results are promising, but with small effect sizes and study limitations, further research is warranted.

PRACTICE IMPLICATIONS

A brief intensive workshop on patient-centered communication tailored to the military screening context is feasible and may improve key outcomes.

摘要

目的

评估以患者为中心的沟通培训对进行部署后健康筛查的军队医疗人员的有效性。这个为期半天的互动研讨会使用视频技术模拟士兵患者。

方法

采用准实验设计,在四至九天的实地考察期间,招募了四个军事治疗机构的所有医疗人员进行数据收集(23名接受培训的医疗人员,28名对照组医疗人员,一名医疗人员拒绝参与)。所有士兵均有资格参与,且对医疗人员的培训状态不知情。在筛查接触后,医疗人员报告他们对心理健康问题的识别情况,士兵报告医疗人员的沟通行为,从而得到1400对匹配数据。还获取了26005名士兵的电子健康记录。

结果

发现该研讨会提高了(1)士兵评估的医疗人员以患者为中心的沟通行为;(2)医疗人员对士兵心理健康问题的识别;以及(3)相关健康结果,包括提供教育和转介至保密咨询资源。

结论

结果很有前景,但效应量较小且存在研究局限性,有必要进一步研究。

实践意义

针对军事筛查背景量身定制的关于以患者为中心沟通的简短强化研讨会是可行的,且可能改善关键结果。

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