Barello Serena, Graffigna Guendalina, Pitacco Giuliana, Mislej Maila, Cortale Maurizio, Provenzi Livio
Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy.
Azienda Sanitaria Universitaria Integrata di Trieste Trieste, Italy.
Front Psychol. 2017 Jan 10;7:2020. doi: 10.3389/fpsyg.2016.02020. eCollection 2016.
Growing evidence recognizes that patients who are motivated to take an active role in their care can experience a range of health benefits and reduced healthcare costs. Nurses play a critical role in the effort to make patients fully engaged in their disease management. Trainings devoted to increase nurses' skills and knowledge to assess and promote patient engagement are today a medical education priority. To address this goal, we developed a program of nurse education training in patient engagement strategies (NET-PES). This paper presents pilot feasibility study and preliminary participants outcomes for NET-PES. This is a pilot feasibility study of a 2-session program on patient engagement designed to improve professional nurses' ability to engage chronic patients in their medical journey; the training mainly focused on passing patient engagement assessment skills to clinicians as a crucial mean to improve care experience. A pre-post pilot evaluation of NET-PES included 46 nurses working with chronic conditions. A course specific competence test has been developed and validated to measure patient engagement skills. The design included self-report questionnaire completed before and after the training for evaluation purposes. Participants met in a large group for didactic presentations and then they were split into small groups in which they used role-play and case discussion to reflect upon the value of patient engagement measurement in relation to difficult cases from own practice. Forty-six nurses participated in the training program. The satisfaction questionnaire showed that the program met the educational objectives and was considered to be useful and relevant by the participants. Results demonstrated changes on clinicians' attitudes and skills in promoting engagement. Moreover, practitioners demonstrated increases on confidence regarding their ability to support their patients' engagement in the care process. Learning programs teaching nurses about patient engagement strategies and assessment measures in clinical practice are key in supporting the realization of patient engagement in healthcare. Training nurses in this area is feasible and accepted and might have an impact on their ability to engage patients in the chronic care journey. Due to the limitation of the research design, further research is needed to assess the effectiveness of such a program and to verify if the benefits envisaged in this pilot are maintained on a long-term perspective and to test results by employing a randomized control study design.
越来越多的证据表明，积极参与自身护理的患者能获得一系列健康益处，并降低医疗成本。护士在促使患者全面参与疾病管理的努力中发挥着关键作用。致力于提高护士评估和促进患者参与能力的技能与知识培训，如今已成为医学教育的重点。为实现这一目标，我们开发了患者参与策略护士教育培训项目（NET-PES）。本文介绍了NET-PES的试点可行性研究及初步参与者成果。这是一项针对患者参与的两阶段项目的试点可行性研究，旨在提高专业护士促使慢性病患者参与医疗过程的能力；培训主要侧重于将患者参与评估技能传授给临床医生，作为改善护理体验的关键手段。NET-PES的试点前后评估纳入了46名从事慢性病护理工作的护士。已开发并验证了一项特定课程能力测试，以衡量患者参与技能。该设计包括培训前后用于评估目的的自我报告问卷。参与者先集中参加理论讲座，然后分成小组，通过角色扮演和案例讨论，反思患者参与度测量在自身实践中处理疑难病例方面的价值。46名护士参加了培训项目。满意度调查问卷显示，该项目达到了教育目标，参与者认为其有用且相关。结果表明，临床医生在促进患者参与方面的态度和技能有所改变。此外，从业者在支持患者参与护理过程的能力方面的信心有所增强。在临床实践中教授护士患者参与策略和评估措施的学习项目，是支持实现患者参与医疗保健的关键。在这一领域培训护士是可行且被认可的，可能会影响他们促使患者参与慢性病护理过程的能力。由于研究设计的局限性，需要进一步研究来评估该项目的有效性，验证本试点中设想的益处是否能长期维持，并采用随机对照研究设计来检验结果。
