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一项全州范围姑息治疗团队培训课程的评估:姑息治疗团队的COMFORT沟通法

Assessment of a Statewide Palliative Care Team Training Course: COMFORT Communication for Palliative Care Teams.

作者信息

Wittenberg Elaine, Ferrell Betty, Goldsmith Joy, Ragan Sandra L, Paice Judith

机构信息

1 Division of Nursing Research and Education, City of Hope Comprehensive Cancer Center , Duarte, California.

2 Department of Communication, University of Memphis , Memphis, Tennessee.

出版信息

J Palliat Med. 2016 Jul;19(7):746-52. doi: 10.1089/jpm.2015.0552. Epub 2016 Jun 10.

Abstract

BACKGROUND

Despite increased attention to communication skill training in palliative care, few interprofessional training programs are available and little is known about the impact of such training.

OBJECTIVE

This study evaluated a communication curriculum offered to interprofessional palliative care teams and examined the longitudinal impact of training.

METHODS

Interprofessional, hospital-based palliative care team members were competitively selected to participate in a two-day training using the COMFORT(TM SM) (Communication, Orientation and options, Mindful communication, Family, Openings, Relating, Team) Communication for Palliative Care Teams curriculum. Course evaluation and goal assessment were tracked at six and nine months postcourse. Interprofessional palliative care team members (n = 58) representing 29 teams attended the course and completed course goals. Participants included 28 nurses, 16 social workers, 8 physicians, 5 chaplains, and one psychologist. Precourse surveys assessed participants' perceptions of institution-wide communication performance across the continuum of care and resources supporting optimum communication. Postcourse evaluations and goal progress monitoring were used to assess training effectiveness.

RESULTS

Participants reported moderate communication effectiveness in their institutions, with the weakest areas being during bereavement and survivorship care. Mean response to course evaluation across all participants was greater than 4 (scale of 1 = low to 5 = high). Participants taught an additional 962 providers and initiated institution-wide training for clinical staff, new hires, and volunteers. Team member training improved communication processes and increased attention to communication with family caregivers. Barriers to goal implementation included a lack of institutional support as evidenced in clinical caseloads and an absence of leadership and funding.

CONCLUSION

The COMFORT(TM SM) communication curriculum is effective palliative care communication training for interprofessional teams.

摘要

背景

尽管姑息治疗中对沟通技能培训的关注度有所提高,但跨专业培训项目却很少,而且对这类培训的影响知之甚少。

目的

本研究评估了为跨专业姑息治疗团队提供的沟通课程,并考察了培训的长期影响。

方法

以医院为基础的跨专业姑息治疗团队成员通过竞争选拔参加为期两天的培训,培训使用姑息治疗团队沟通课程(COMFORT™ SM,即沟通、方向与选择、正念沟通、家庭、开场、关系、团队)。在课程结束后的6个月和9个月跟踪课程评估和目标评估。代表29个团队的58名跨专业姑息治疗团队成员参加了课程并完成了课程目标。参与者包括28名护士、16名社会工作者、8名医生、5名牧师和1名心理学家。课程前的调查评估了参与者对整个护理连续过程中机构范围内沟通表现以及支持最佳沟通的资源的看法。课程后的评估和目标进展监测用于评估培训效果。

结果

参与者报告称其所在机构的沟通有效性处于中等水平,最薄弱的环节是在丧亲之痛和幸存者护理期间。所有参与者对课程评估的平均回复大于4(1 = 低至5 = 高)。参与者又培训了962名提供者,并为临床工作人员、新员工和志愿者启动了全机构范围的培训。团队成员培训改善了沟通流程,并增加了对与家庭照顾者沟通的关注。目标实施的障碍包括临床工作量所显示的缺乏机构支持,以及缺乏领导力和资金。

结论

COMFORT™ SM沟通课程是针对跨专业团队的有效的姑息治疗沟通培训。

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