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将共同决策纳入与老年癌症患者及其照护者的沟通中:老年共同决策沟通技能培训模块的开发和评估。

Incorporating shared decision making into communication with older adults with cancer and their caregivers: Development and evaluation of a geriatric shared decision-making communication skills training module.

机构信息

Weill Cornell Medical College, Department of Medicine, United States.

Memorial Sloan Kettering Cancer Center, Department of Geriatrics, United States.

出版信息

Patient Educ Couns. 2020 Nov;103(11):2328-2334. doi: 10.1016/j.pec.2020.04.032. Epub 2020 May 5.

Abstract

OBJECTIVE

The purpose of this study was to evaluate a Communication Skills Training (CST) module for health care providers (HCPs) applying a shared decision-making approach to a meeting with an older adult with cancer and his/her family.

METHODS

Ninety-nine HCPs from community-based centers, cancer centers, and hospitals in the Northeastern U.S. who worked primarily with older adult patients participated in a CST module entitled Geriatric Shared Decision Making. Participants completed pre- and post-training Standardized Patient Assessments (SPAs) and a survey on their confidence in and intent to utilize skills taught.

RESULTS

Results indicated high HCP satisfaction with the module, with over 95 % of participants reporting high endorsement to all five evaluation items. HCPs' self-efficacy in utilizing communication skills related to geriatric shared decision making significantly increased pre- to post-training. In standardized patient assessments among a subset of providers (n = 30), HCPs demonstrated improvements in three shared decision-making skills: declare agenda, invite agenda, and check preference.

CONCLUSION

A geriatric shared decision-making CST workshop for HCPs showed feasibility, acceptability, and improvement in self-efficacy as well as skill uptake.

PRACTICE IMPLICATIONS

This Geriatric Shared Decision-Making CST module provides an intervention for improving provider-patient-family member communication in the context of cancer care for older adults.

摘要

目的

本研究旨在评估一项针对医疗保健提供者(HCPs)的沟通技巧培训(CST)模块,该模块采用共同决策方法与癌症老年患者及其家属进行会面。

方法

来自美国东北部社区中心、癌症中心和医院的 99 名主要为老年患者服务的 HCPs 参加了一个名为老年共同决策的 CST 模块。参与者在培训前后完成了标准化患者评估(SPA),并对他们对所学技能的信心和应用意图进行了调查。

结果

结果表明,HCPs 对该模块非常满意,超过 95%的参与者对所有五个评估项目都给予了高度认可。HCPs 在与老年共同决策相关的沟通技巧的自我效能感在培训前后显著提高。在一部分提供者(n=30)的标准化患者评估中,HCPs 在三个共同决策技能方面有所提高:宣布议程、邀请议程和检查偏好。

结论

一项针对 HCPs 的老年共同决策 CST 研讨会显示出可行性、可接受性以及自我效能感的提高和技能的采用。

实践意义

这个老年共同决策 CST 模块为改善癌症老年患者护理中提供者-患者-家庭成员的沟通提供了一种干预措施。

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Communication involving special populations: older adults with cancer.涉及特殊人群的沟通:癌症老年患者。
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