Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Division of Hematology & Oncology, College of Medicine, University of Florida, Gainesville, FL, USA.
Transl Behav Med. 2021 Mar 16;11(2):613-618. doi: 10.1093/tbm/ibaa011.
Most lung cancer patients report perceiving stigma surrounding their diagnosis, and routine clinical interactions with their health care providers (HCPs) are reported as a common source. The adverse effects of lung cancer stigma are associated with several adverse psychosocial and behavioral outcomes. One potential clinician-level intervention target is empathic communication because of its association with higher rates of patients' satisfaction, treatment adherence, and lower levels of psychological distress. This study describes the conceptual model and evaluation of clinician-targeted empathic communication skills training to reduce lung cancer patients' experience of stigma. The goal of the training module is to enhance clinician recognition and responsiveness to lung cancer patients' empathic opportunities by communicating understanding, reducing stigma and distress, and providing support. Thirty multidisciplinary HCPs working in thoracic oncology, thoracic surgery, or pulmonary medicine participated in 2.25 hr of didactic and experiential training on responding empathically to patients with lung cancer. Overall, participants reported highly favorable evaluations of the training, with at least 90% of participants agreeing or strongly agreeing to 11 of the 12 items assessing clinical relevance, novelty, clarity, and facilitator effectiveness. Participants' self-efficacy to communicate empathically with lung cancer patients increased significantly from pretraining to posttraining, t(29) = -4.58, p < .001. The empathic communication skills training module was feasible and well received by thoracic and pulmonary medicine HCPs and demonstrated improvements in self-efficacy in empathic communication from pretraining to posttraining. The examination of patient outcomes is warranted.
大多数肺癌患者报告称，他们在诊断过程中感受到了耻辱感，而与医疗保健提供者（HCPs）的常规临床互动被认为是一个常见的来源。肺癌耻辱感的不良影响与一些不良的心理社会和行为结果有关。共情沟通是一个潜在的临床医生干预目标，因为它与患者满意度、治疗依从性的提高以及心理困扰程度的降低有关。本研究描述了针对临床医生的共情沟通技能培训的概念模型和评估，以减少肺癌患者的耻辱感体验。培训模块的目标是通过传达理解、减少耻辱感和痛苦以及提供支持，增强临床医生对肺癌患者共情机会的识别和反应能力。30 名从事胸肿瘤学、胸外科或肺病学的多学科 HCP 参加了 2.25 小时的关于对肺癌患者进行共情反应的理论和实践培训。总的来说，参与者对培训的评价非常高，至少有 90%的参与者对评估临床相关性、新颖性、清晰度和促进者有效性的 12 项中的 11 项表示同意或强烈同意。参与者与肺癌患者进行共情沟通的自我效能感在培训前后显著增加，t(29)=-4.58，p<0.001。共情沟通技能培训模块在胸科和肺病科 HCP 中是可行的，且受到了欢迎，并在培训前后自我效能感的共情沟通方面取得了显著提高。需要进一步研究患者的结果。
