Tanuma Kazunori, Watanabe Fumiyuki, Maeda Hatsuyo, Saitoh Nobutaka, Kamei Miwako
Kamegaya Co. Ltd. (Fit Care Depot).
Study Group for Patient Counseling Using CBT-A.
Yakugaku Zasshi. 2019;139(1):97-106. doi: 10.1248/yakushi.18-00115.
To enable community pharmacists to provide empathic patient counseling, we developed and validated a training program based on the cognitive behavioral therapy approach (CBT-A) in our previous study. The major focus points of the re-structured training program were "inclusion of basic communication skills", "exemplifying correspondence involving CBT-A using pre-recorded video(VTR)", and "approach methods for cases where counter-evidence is unavailable". The training program lasted for 4 h per day, for a total of 8 h. We also performed role-play scenarios on information gathering and medication guidance for simulated patients before and after training, and evaluated patient satisfaction with counseling, patient counseling alliance scores, and the degrees of the psychological distance between patients and pharmacists. Participants had high satisfaction with the discussion and role-play aspects of the training, as in our previous study. Participants also showed high satisfaction with "exemplifying correspondence involving CBT-A using VTR". Counseling time was significantly longer when using CBT-A compared to ordinary information gathering and medication guidance, but patient satisfaction and patient counseling alliance scores were both higher, and the psychological distance between patient and pharmacist was lower. Accordingly, if patients cannot solve their own problems, even when pharmacists provide polite responses and expertise, patients can be guided in their problem solving using CBT-A. It suggested that using CBT-A could solve the problem of patients with anxiety due to problems that cannot be solved only via drug-centered approach.
为使社区药剂师能够提供共情的患者咨询服务,我们在之前的研究中开发并验证了一种基于认知行为疗法方法(CBT - A)的培训项目。重新构建的培训项目的主要重点是“纳入基本沟通技巧”、“使用预录制视频(VTR)举例说明涉及CBT - A的沟通方式”以及“针对无反证情况的处理方法”。培训项目每天持续4小时,共计8小时。我们还在培训前后针对模拟患者进行了信息收集和用药指导的角色扮演场景,并评估了患者对咨询的满意度、患者咨询联盟得分以及患者与药剂师之间的心理距离程度。与我们之前的研究一样,参与者对培训中的讨论和角色扮演部分满意度较高。参与者对“使用VTR举例说明涉及CBT - A的沟通方式”也表现出较高的满意度。与普通的信息收集和用药指导相比,使用CBT - A时咨询时间明显更长,但患者满意度和患者咨询联盟得分都更高,并且患者与药剂师之间的心理距离更低。因此,如果患者自身无法解决问题,即使药剂师提供礼貌的回应和专业知识,也可以使用CBT - A指导患者解决问题。这表明使用CBT - A可以解决仅通过以药物为中心的方法无法解决问题而导致焦虑的患者的问题。