Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
Pediatric Oncology, Dana-Farber Cancer Institute, Pediatrics, Boston Children's Hospital, Boston, MA, USA.
Patient Educ Couns. 2019 Dec;102(12):2344-2348. doi: 10.1016/j.pec.2019.07.023. Epub 2019 Jul 24.
Responding to emotion is a central function of communication in medicine. However, many clinicians miss opportunities to engage their patients' emotions, and these lapses can negatively affect the patient's relationship with the clinician. As such, responding to emotion serves as a useful example of communication challenges in cancer care. The clinician's response to emotion is likely influenced by cognitive, social, economic, and cultural factors. In psychology, models of behavioral change seek to understand and predict how individuals will act in specific circumstances by incorporating these multiple determinants. However, behavioral change models have not been applied specifically or rigorously to clinicians' communication behaviors in oncology. In this article, we argue that applying such models in oncology can provide benefits to clinicians and communication researchers. To frame this argument, we will apply the Information-Motivation-Behavioral Skills (IMBS) model of behavioral change to communication about emotion in oncology. We will then propose specific ways in which applying behavioral change models to communication can benefit clinicians and patients. Improving communication behaviors requires more than commonsense solutions. Behavioral change models might support the enactment of communication skills and knowledge, bridging the gap between "knowing" and "doing."
回应情绪是医学沟通的核心功能之一。然而，许多临床医生错过了与患者的情绪互动的机会，这些疏忽可能会对患者与临床医生的关系产生负面影响。因此，回应情绪是癌症护理中沟通挑战的一个很好的例子。临床医生对情绪的反应可能受到认知、社会、经济和文化因素的影响。在心理学中，行为改变模型试图通过纳入这些多种决定因素来理解和预测个人在特定情况下的行为。然而，行为改变模型尚未专门或严格地应用于肿瘤学中的临床医生沟通行为。在本文中，我们认为将这些模型应用于肿瘤学可以为临床医生和沟通研究人员带来益处。为了说明这一点，我们将应用行为改变的信息-动机-行为技能（IMBS）模型来分析肿瘤学中关于情绪的沟通。然后，我们将提出将行为改变模型应用于沟通可以使临床医生和患者受益的具体方式。改善沟通行为需要的不仅仅是常识性的解决方案。行为改变模型可以支持沟通技巧和知识的实施，弥合“知道”和“做”之间的差距。
