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沟通技巧培训能否实现症状和痛苦筛查?培训对放射治疗师进行痛苦筛查的信心、知识和使用的影响。

Does a communication skills program enable symptom and distress screening?: The impact of training on radiation therapists' confidence, knowledge, and use of distress screening.

机构信息

Illawarra Shoalhaven Local Health District, New South Wales, Australia; Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia.

Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia.

出版信息

J Med Imaging Radiat Sci. 2021 Sep;52(3):399-408. doi: 10.1016/j.jmir.2021.05.011. Epub 2021 Jun 26.

Abstract

INTRODUCTION

Due to the prevalence of distress following a cancer diagnosis, routine symptom and distress screening is recommended as best practice. RTs perceive psychosocial support and screening to be part of their role, however feel they lack the education and skills to perform this confidently. The study aimed to evaluate the impact of providing communication skills training (RT Prepare CST) on the perceived barriers, knowledge, attitude, role, and confidence of radiation therapists (RTs) in using routine symptom and distress screening.

METHODS

A single-arm, pre-post intervention design was implemented. All RTs at one regional and one rural centre participated in RT Prepare CST. RTs completed a questionnaire: pre-intervention (T1); immediately post-intervention (T2); and, three months post-intervention (T3). Cochran's Q and McNemar's tests for non-parametric data were conducted to compare outcomes over time.

RESULTS

Of 39 RTs approached, 37 (95%) consented to participate with 36 (92%) completing questionnaires at all three time points. Significant and sustained improvements post-intervention were noted from T1-T3 including: confidence in describing the PROMPT-Care tool to patients (p=0.002), discussing psychosocial issues (p=0.014); recognising signs of anxiety/depression (p<0.001); dealing with signs of anxiety (p=0.002), depression (p=0.015) and distress (p=0.008) as well as agreeing 'the tool is useful in identifying psychosocial problems' (p=0.029).

CONCLUSIONS

RT Prepare CST was effective in increasing confidence, knowledge and attitudes of RTs in the psychosocial care of patients with a change in RT behaviour noted by a significant increase in the number of patients screened following the intervention. Providing routine CST and emotional cues training to RTs enhances their ability to care for patients holistically, equipping them with skills to be included within a psychosocial model of care. Engaged leadership and role models are essential to sustain the learnings from education programs and provide an environment to discuss and define roles within radiation therapy departments.

摘要

简介

由于癌症诊断后普遍存在痛苦,因此建议常规进行症状和痛苦筛查,这是最佳实践。放射治疗师(RT)认为提供心理社会支持和筛查是其职责的一部分,但他们觉得自己缺乏进行此项工作的教育和技能。本研究旨在评估提供沟通技巧培训(RT Prepare CST)对放射治疗师(RT)使用常规症状和痛苦筛查的感知障碍、知识、态度、角色和信心的影响。

方法

采用单臂、干预前后设计。一家地区中心和一家农村中心的所有 RT 都参加了 RT Prepare CST。RT 在干预前(T1)、干预后即刻(T2)和干预后三个月(T3)完成问卷。对于非参数数据,采用 Cochran's Q 和 McNemar 检验进行比较。

结果

在 39 名被接触的 RT 中,有 37 名(95%)同意参与,其中 36 名(92%)在所有三个时间点完成了问卷。T1 到 T3 之间,干预后显著和持续的改善包括:有信心向患者描述 PROMPT-Care 工具(p=0.002)、讨论心理社会问题(p=0.014);识别焦虑/抑郁的迹象(p<0.001);处理焦虑(p=0.002)、抑郁(p=0.015)和痛苦(p=0.008)的迹象,以及同意“该工具有助于识别心理社会问题”(p=0.029)。

结论

RT Prepare CST 有效提高了 RT 对患者心理社会护理的信心、知识和态度,并且 RT 行为发生了变化,干预后筛查患者的人数显著增加。为 RT 提供常规 CST 和情绪线索培训,增强了他们全面照顾患者的能力,使他们具备技能,成为心理社会护理模式的一部分。有能力的领导和榜样对于保持教育项目的学习成果以及提供讨论和定义放射治疗部门角色的环境至关重要。

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