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为医疗保健专业人员制定培训计划,以改善与低健康素养患者的乳腺癌遗传咨询沟通。

Systematic development of a training program for healthcare professionals to improve communication about breast cancer genetic counseling with low health literate patients.

机构信息

Division Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.

Pharos, Dutch Center of Expertise on Health Disparities, Utrecht, The Netherlands.

出版信息

Fam Cancer. 2020 Oct;19(4):281-290. doi: 10.1007/s10689-020-00176-3.

Abstract

There is a disproportionate underuse of genetic testing in breast cancer patients from lower education or migrant background. Within these groups, communication about referral to genetic counseling appears challenging due to limited health literacy and cultural barriers. Our aim was to develop and evaluate a training program for healthcare professionals (breast surgeons and specialized nurses), to increase effective communication. We systematically developed a blended training program based on patients' and healthcare professionals' needs and preferences. Prior to the training, we assessed awareness, knowledge and self-efficacy of healthcare professionals. Acceptability and usefulness of the training program were assessed directly after the training. Healthcare professionals (n = 65) from 17 hospitals showed moderate to high awareness and knowledge about the prevalence and impact of limited health literacy. They were aware of cultural factors that influence communication. However, they did not feel confident in recognizing limited health literacy and their self-efficacy to communicate effectively with these patients was low. The training program was rated as acceptable and useful. Healthcare professionals lack confidence to effectively communicate with patients with limited health literacy or migrant background. The training program offers opportunities to improve communication about referral to breast cancer genetic counseling.

摘要

在受教育程度较低或移民背景的乳腺癌患者中,基因检测的使用明显不足。在这些群体中,由于健康素养有限和文化障碍,关于转介至遗传咨询的沟通似乎具有挑战性。我们的目的是为医疗保健专业人员(乳腺外科医生和专科护士)开发和评估一项培训计划,以提高有效沟通的能力。我们基于患者和医疗保健专业人员的需求和偏好,系统地开发了一个混合培训计划。在培训之前,我们评估了医疗保健专业人员的意识、知识和自我效能。培训结束后直接评估培训计划的可接受性和有用性。来自 17 家医院的 65 名医疗保健专业人员对健康素养有限的普遍性和影响有中等至高的认识和了解。他们意识到影响沟通的文化因素。然而,他们对识别健康素养有限并不自信,他们与这些患者有效沟通的自我效能感较低。培训计划被评为可接受和有用。医疗保健专业人员缺乏与健康素养有限或移民背景的患者有效沟通的信心。培训计划为改善关于乳腺癌遗传咨询转介的沟通提供了机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/786b/7497313/ab82a38f3343/10689_2020_176_Fig1_HTML.jpg

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