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不良消息咨询中的情感沟通。对模拟患者心率变异性和回忆的影响。

Affective communication during bad news consultation. Effect on analogue patients' heart rate variability and recall.

机构信息

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.

Department of Information Engineering, and Bioengineering and Robotics Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy.

出版信息

Patient Educ Couns. 2018 Nov;101(11):1892-1899. doi: 10.1016/j.pec.2018.06.009. Epub 2018 Jun 19.

Abstract

OBJECTIVE

The aim of the study was to investigate the effect of physicians' supportive communication on analogue patients' (APs) heart rate variability (HRV) and recall, while watching a video of palliative treatment being explained to a female patient.

METHODS

Sixty healthy women, acting as APs, were randomly assigned to watch one of two versions (standard vs. affective) of a scripted video-vignette of a bad news consultation to a female patient. The physician's communication differed only in the delivery of four supportive comments. Empathy, support and engagement perception were assessed by three questions. APs' HR was recorded during video-observation and recall was assessed immediately after. HRV was determined through measures defined in time and frequency domains.

RESULTS

Data of 54 APs (27 + 27) were included. The group with supportive communication perceived the physician as more empathic and supportive. Intra- and Inter-group comparisons suggested a greater sense of stress in the standard communication group. Recall did not differ in the two groups.

CONCLUSION AND PRACTICE IMPLICATIONS

Findings show that the use of supportive expressions contribute to the perception of the physician as more empathic, potentially buffer patients' arousal after a bad news announcement, but does not confirm a positive impact on general recall.

摘要

目的

本研究旨在探讨医生的支持性沟通对模拟患者(APs)心率变异性(HRV)和回忆的影响,同时观察向女性患者解释姑息治疗的视频。

方法

60 名健康女性作为 APs,随机分配观看女性患者不良预后咨询脚本视频片段的两个版本(标准与情感)之一。医生的沟通仅在四个支持性评论的传达上有所不同。同理心、支持和参与感知通过三个问题进行评估。在视频观察期间记录 APs 的 HR,并在观察后立即评估回忆。通过时域和频域定义的措施确定 HRV。

结果

纳入 54 名 APs(27+27)的数据。支持性沟通组感知医生更有同理心和支持。组内和组间比较表明标准沟通组的压力感更大。两组的回忆没有差异。

结论和实践意义

研究结果表明,支持性表达的使用有助于医生被感知为更有同理心,可能在不良消息公布后缓冲患者的唤醒,但不能证实对一般回忆有积极影响。

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