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体验式教育增强护理人员与老年患者的视角和人际沟通能力:一项对照研究。

Experiential education enhancing paramedic perspective and interpersonal communication with older patients: a controlled study.

机构信息

Department of Community Emergency Health & Paramedic Practice, Monash University, PO Box 527, McMahons Road, Frankston, VIC, 3199, Australia.

Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia.

出版信息

BMC Med Educ. 2018 Oct 20;18(1):239. doi: 10.1186/s12909-018-1341-9.

Abstract

BACKGROUND

Paramedics are required to provide care to an aging population with multidimensional and complex issues. As such educators need to prepare undergraduate paramedics to recognise, assess and manage a broad range of psychosocial care and support issues beyond somatic conditions. Experiential educational interventions with older people provide realistic and contextualised experience which can improve the provision of holistic patient focused care.

METHODS

This was a single institution controlled before-after study with parallel groups, conducted in Australia in 2017. It was designed to compare the effectiveness of an educational program related to older people (intervention), verses no intervention (control) on paramedic student attitudes, knowledge and behavior with older patients.

RESULTS

A total of 124 second year paramedic students were included in this study; 60 in the intervention and 64 in the control group. Their demographics and Time 1 baseline results were homogeneous. Both groups showed improvement in communication skills with real older patients (p < 0.001, η = 0.41) and (p < 0.001, η = 0.35). The intervention group showed greater improvements in the 'understands the patient's perspective' element for both the self-assessment (p < 0.001) and the clinician assessment (p = 0.01). Multiple linear regression Model 1 found gender (β = - 0.25; p = 0.01) was the best predictor of clinician-assessed communication, with females having higher scores. Knowledge and attitudes remained relatively unchanged for both groups.

CONCLUSIONS

As the first study to observe, measure and report on the interpersonal communication skills of paramedic student's with 'real' older patients we can report that these skills were from fair to good at baseline and improved from good to very good post the intervention. Overall improvement was notably better in the 'understanding the patients perspective element' for the intervention group who had conducted one-one visits with an older person.

摘要

背景

护理人员需要为具有多维和复杂问题的老年人群提供护理。因此,教育者需要使本科护理人员能够识别、评估和管理广泛的心理社会护理和支持问题,而不仅仅是躯体疾病。与老年人进行体验式教育干预可以提供现实和背景化的经验,从而改善整体以患者为中心的护理服务。

方法

这是一项在澳大利亚于 2017 年进行的单机构对照前后研究,采用平行组设计,旨在比较与老年人相关的教育计划(干预组)与无干预(对照组)对护理学生与老年患者互动的态度、知识和行为的影响。

结果

本研究共纳入 124 名二年级护理学生;干预组 60 人,对照组 64 人。两组的人口统计学和基线结果均相似。两组与真实老年患者的沟通技能均有提高(p<0.001,η=0.41)和(p<0.001,η=0.35)。干预组在自我评估(p<0.001)和临床医生评估(p=0.01)中“理解患者的观点”要素上的改善更为显著。模型 1 的多元线性回归发现,性别(β=-0.25;p=0.01)是临床医生评估沟通的最佳预测指标,女性得分更高。两组的知识和态度相对保持不变。

结论

作为第一项观察、衡量和报告护理学生与“真实”老年患者的人际沟通技能的研究,我们可以报告,这些技能在干预前处于中等至良好水平,干预后从良好提高到非常好。干预组在“理解患者观点”要素方面的整体改善更为显著,他们对老年人进行了一对一的访问。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c57/6195953/1e258d8d54c2/12909_2018_1341_Fig1_HTML.jpg

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