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学生药剂师为英语水平有限的标准化患者提供阿片类药物咨询:一项前后教育干预研究。

Student pharmacist opioid consultations with standardized limited English proficiency patients: A pre-post educational intervention study.

机构信息

Social and Administrative Sciences in Pharmacy Division, University of Wisconsin-Madison School of Pharmacy, United States.

PGY2 Pharmacy Resident - Ambulatory Care Setting, University of Iowa Hospitals and Clinics, United States.

出版信息

Curr Pharm Teach Learn. 2021 Feb;13(2):146-151. doi: 10.1016/j.cptl.2020.09.006. Epub 2020 Oct 12.

Abstract

BACKGROUND AND PURPOSE

This study explored the effect of a structured educational intervention for student pharmacists to counsel limited English proficiency (LEP) patients on risks and safety of opioid medications for chronic pain. Specific aims were to compare 2018 pre-intervention versus 2019 post-intervention groups regarding: (1) dose and side effects discussed, (2) opioid risks and safety measures covered, and (3) LEP specific communication practices.

EDUCATIONAL ACTIVITY AND SETTING

Third-year student pharmacists (P3s) in a required communications course consulted LEP standardized patients (SPs) on opioid medications in 2018 and 2019. An educational intervention for the 2019 P3s consisted of a 50-min lecture, pre-lab instructions about techniques for communication about opioid risks and safety, and for LEP specific communication stressing teach-back. All consultations in the pre- and post-intervention phases were video recorded and quantitatively coded for verbal and non-verbal communication skills. Descriptive statistics and Fisher's exact tests were conducted on data.

FINDINGS

Twenty-three consultations were recorded in 2018 for the pre-intervention phase and 49 consultations were recorded in 2019 for the post-intervention phase. Only 17% of students in the pre- intervention phase called the medication an "opioid" or "narcotic" in the consultation as compared to 84% in the post-intervention phase. While 100% of students in the post-intervention phase used teach-back, only 61% did so in the pre-intervention group. Significant differences between the two groups were observed for minimizing dependency and overdose, offering naloxone, teach-back, integrating a patient handout into the consultation, and discussing use of alternate pain medications.

摘要

背景与目的

本研究探讨了一项针对学生药剂师的结构化教育干预措施,以指导他们为有限英语水平(LEP)患者提供有关阿片类药物治疗慢性疼痛的风险和安全性方面的建议。具体目标是比较 2018 年干预前组和 2019 年干预后组在以下方面的差异:(1)讨论的剂量和副作用,(2)涵盖的阿片类药物风险和安全措施,以及(3)针对 LEP 患者的特定沟通实践。

教育活动和设置

在一门必修沟通课程中,三年级学生药剂师(P3)在 2018 年和 2019 年与 LEP 标准化患者(SP)就阿片类药物进行了咨询。针对 2019 年的 P3 学生,教育干预包括 50 分钟的讲座、关于沟通阿片类药物风险和安全以及针对 LEP 患者的特定沟通技巧(强调“回授教学法”)的预实验指导。在干预前和干预后阶段的所有咨询都进行了视频记录,并对言语和非言语沟通技巧进行了定量编码。对数据进行了描述性统计和 Fisher 精确检验。

结果

在干预前阶段记录了 23 次咨询,在干预后阶段记录了 49 次咨询。在干预前阶段,只有 17%的学生在咨询中称药物为“阿片类药物”或“麻醉性药物”,而在干预后阶段,这一比例上升至 84%。尽管在后干预组中 100%的学生使用了“回授教学法”,但在前干预组中,只有 61%的学生使用了这种方法。在后干预组中,在最小化依赖性和过量、提供纳洛酮、使用“回授教学法”、将患者手册纳入咨询以及讨论替代疼痛药物的使用方面,两组之间存在显著差异。

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