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采取热行动:一项关于改善与愤怒家属沟通的试点研究。

Take the HEAT: A pilot study on improving communication with angry families.

作者信息

Delacruz Nicolas, Reed Suzanne, Splinter Ansley, Brown Amy, Flowers Stacy, Verbeck Nicole, Turpening Debbie, Mahan John D

机构信息

The Ohio State University College of Medicine, 370 W 9th Avenue, Columbus, OH 43210, USA.

Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH 43205, USA.

出版信息

Patient Educ Couns. 2017 Jun;100(6):1235-1239. doi: 10.1016/j.pec.2016.12.012. Epub 2016 Dec 19.

Abstract

OBJECTIVE

Our objective was to evaluate the utility of an educational program consisting of a workshop based on the Take the HEAT communication strategy, designed specifically for addressing patients who are angry, using a novel tool to evaluate residents' skills in employing this method.

METHODS

33 first-year pediatric and internal medicine-pediatrics residents participated in the study. The workshop presented the Take the HEAT (Hear, Empathize, Apologize, Take action) strategy of communication. Communication skills were assessed through standardized patient encounters at baseline and post-workshop. Encounters were scored using a novel assessment tool.

RESULTS

After the workshop, residents' Take the HEAT communication improved from baseline total average score 23.15 to total average score 25.36 (Z=-3.428, p<0.001). At baseline, empathy skills were the lowest. Intraclass Correlation Coefficient demonstrated substantial agreement (0.60 and 0.61) among raters using the tool.

CONCLUSION

First-year pediatric trainees' communication with angry families improved with education focused on the Take the HEAT strategy. Poor performance by residents in demonstrating empathy should be explored further.

PRACTICE IMPLICATIONS

This study demonstrates the utility of a brief communications curriculum aimed at improving pediatric residents' ability to communicate with angry families.

摘要

目的

我们的目的是评估一项教育计划的效用,该计划包括一个基于“采取HEAT沟通策略”的工作坊,该策略是专门为应对愤怒的患者而设计的,使用一种新颖的工具来评估住院医师运用这种方法的技能。

方法

33名儿科和内科-儿科一年级住院医师参与了该研究。工作坊介绍了“采取HEAT(倾听、共情、道歉、采取行动)”沟通策略。通过在基线和工作坊结束后的标准化患者接触来评估沟通技能。使用一种新颖的评估工具对接触情况进行评分。

结果

工作坊结束后,住院医师的“采取HEAT”沟通能力从基线总平均分23.15提高到总平均分25.36(Z=-3.428,p<0.001)。在基线时,共情技能最低。组内相关系数显示,使用该工具的评估者之间具有高度一致性(0.60和0.61)。

结论

针对一年级儿科住院医师开展的以“采取HEAT策略”为重点的教育,改善了他们与愤怒家属的沟通。住院医师在表现共情方面的不佳表现应进一步探讨。

实践意义

本研究证明了一个简短的沟通课程在提高儿科住院医师与愤怒家属沟通能力方面的效用。

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