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参与行动研究如何改变我们对共同决策培训挑战的看法。

How participatory action research changed our view of the challenges of shared decision-making training.

机构信息

Health Services Research Unit, Lillebaelt Hospital, Denmark; Institute for Regional Health Research, University of Southern Denmark, Denmark.

Health Services Research Unit, Lillebaelt Hospital, Denmark; Institute for Regional Health Research, University of Southern Denmark, Denmark.

出版信息

Patient Educ Couns. 2018 Apr;101(4):639-646. doi: 10.1016/j.pec.2017.11.002. Epub 2017 Nov 9.

DOI:10.1016/j.pec.2017.11.002
PMID:29137836
Abstract

OBJECTIVE

This paper aims to demonstrate how the use of participatory action research (PAR) helped us identify ways to respond to communication challenges associated with shared decision-making (SDM) training.

METHODS

Patients, relatives, researchers, and health professionals were involved in a PAR process that included: (1) two theatre workshops, (2) a pilot study of an SDM training module involving questionnaires and evaluation meetings, and (3) three reflection workshops.

RESULTS

The PAR process revealed that health professionals often struggled with addressing existential issues such as concerns about life, relationships, meaning, and ability to lead responsive dialogue. Following the PAR process, a communication programme that included communication on existential issues and coaching was drafted.

CONCLUSION

By involving multiple stakeholders in a comprehensive PAR process, valuable communication skills addressing a broader understanding of SDM were identified. A communication programme aimed to enhance skills in a mindful and responsive clinical dialogue on the expectations, values, and hopes of patients and their relatives was drafted.

PRACTICAL IMPLICATIONS

Before integrating new communication concepts such as SDM in communication training, research methods such as PAR can be used to improve understanding and identify the needs and priorities of both patients and health professionals.

摘要

目的

本文旨在展示参与式行动研究(PAR)如何帮助我们确定应对与共享决策(SDM)培训相关的沟通挑战的方法。

方法

患者、家属、研究人员和卫生专业人员参与了一个 PAR 过程,包括:(1)两个戏剧工作坊,(2)涉及问卷调查和评估会议的 SDM 培训模块的试点研究,以及(3)三个反思工作坊。

结果

PAR 过程揭示了卫生专业人员在解决存在问题(如对生命、关系、意义和能力的担忧)方面经常面临困难。在 PAR 过程之后,起草了一个包含关于存在问题和指导的沟通方案。

结论

通过让多个利益相关者参与全面的 PAR 过程,确定了有价值的沟通技能,以更广泛地理解 SDM。起草了一个沟通方案,旨在增强在有意义和响应性的临床对话中关于患者及其家属的期望、价值观和希望的技能。

实用意义

在将新的沟通概念(如 SDM)融入沟通培训之前,可以使用 PAR 等研究方法来提高对患者和卫生专业人员的需求和优先事项的理解和识别。

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