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一项促进护理专业学生对护理人员健康风险行为进行换位思考的随机对照试点研究。

: A randomized, controlled pilot study to promote nursing student perspective-taking on carers' health risk behaviors.

作者信息

Lobchuk Michelle, Hoplock Lisa, Halas Gayle, West Christina, Dika Cheryl, Schroeder Wilma, Ashcroft Terri, Clouston Kathleen Chambers, Lemoine Jocelyne

机构信息

1Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Room 315 - 89 Curry Place, Winnipeg, MB R3T 2N2 Canada.

2Max Rady Faculty of Health Sciences, College of Medicine, University of Manitoba, P228-770, Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada.

出版信息

BMC Nurs. 2018 May 24;17:21. doi: 10.1186/s12912-018-0291-1. eCollection 2018.

Abstract

BACKGROUND

Lifestyle counseling is described as a "major breakthrough" in the control of chronic diseases. Counseling can be challenging to nurses due their lack of motivation to counsel, hesitancy to appear non-judgmental, lack of empathy, and lack of time. Nurses voice their need for more training in counseling communication skills. Our main objective was to engage in ongoing development and testing of a promising perspective-taking intervention on nursing students' clinical empathy, perceptual understanding, and client readiness to alter health risk behaviors.

METHODS

In this randomized controlled pilot study, the full intervention (perspective-taking instructions, practice, and video-feedback) and partial intervention (video-feedback only) comprised 24 and 18 nursing students, respectively. Quantitative data were collected with a 10-item pre- and post-intervention clinical empathy tool, a one-item 'readiness to change' health risk behavior tool plus similarity ratings on students' empathic accuracy were calculated. Data were analyzed using Independent Samples t Tests and mixed model ANCOVA models. Students' and actors' evaluative responses toward the intervention phases were collected by handwritten notes, and analyzed using content analysis and constant comparison techniques.

RESULTS

The main finding was that students in the full intervention group reported greater clinical empathy in the post versus baseline condition. Students underestimated their clinical empathy in comparison to carers' reports in the post-condition. In both intervention groups, carers reported more readiness to change in the post-condition. Carers identified favorable and unfavorable . Students desired immediate and direct feedback after the video-dialogue and -tagging exercise.

CONCLUSIONS

is a promising intervention to help educators in basic and continuing education to bolster nurse confidence in empathic conversations on health risk behaviors. This intervention incorporates commonly used strategies to teach empathic communication along with a novel video-analysis application of a perspective-taking task. Student and carer actor comments highlighted the value in opportunities for students to engage in self-evaluation and practicing the empathic process of taking the client's perspective on health risk behaviors.

摘要

背景

生活方式咨询被视为慢性病控制领域的一项“重大突破”。由于缺乏咨询动力、担心表现出评判性、缺乏同理心以及时间不足,咨询工作对护士来说可能具有挑战性。护士们表示需要更多关于咨询沟通技巧的培训。我们的主要目标是持续开展并测试一种有前景的换位思考干预措施,以提升护理专业学生的临床同理心、感知理解能力以及服务对象改变健康风险行为的意愿。

方法

在这项随机对照试验性研究中,完整干预组(包括换位思考指导、实践和视频反馈)和部分干预组(仅视频反馈)分别有24名和18名护理专业学生。通过一份包含10个条目的干预前后临床同理心工具收集定量数据,使用一份关于“改变意愿”的健康风险行为单项工具,并计算学生共情准确性的相似性评分。数据采用独立样本t检验和混合模型协方差分析模型进行分析。通过手写笔记收集学生和参与者对干预阶段的评价性反馈,并采用内容分析和持续比较技术进行分析。

结果

主要发现是,完整干预组的学生在干预后比基线状态下报告了更高的临床同理心。与护理人员在干预后的报告相比,学生低估了自己的临床同理心。在两个干预组中,护理人员报告在干预后更愿意改变。护理人员指出了有利和不利的方面。学生们希望在视频对话和标记练习后能得到即时和直接的反馈。

结论

这是一项有前景的干预措施,可帮助基础和继续教育的教育工作者增强护士在关于健康风险行为的共情对话中的信心。该干预措施结合了常用的共情沟通教学策略以及一项新颖的换位思考任务视频分析应用。学生和护理人员参与者的评论强调了让学生有机会进行自我评价并练习从服务对象角度看待健康风险行为的共情过程的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6158/5968556/e12d1b8749b3/12912_2018_291_Fig1_HTML.jpg

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