Tomassetti Sara, Sebastiani Alfredo, Caminati Antonella, Oggionni Tiberio, Davì Michele, Ghirardini Alessandra, Martinoli Monica M
Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy.
Present address: Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy.
Sarcoidosis Vasc Diffuse Lung Dis. 2021;38(3):e2021042. doi: 10.36141/svdld.v38i3.11400. Epub 2021 Sep 30.
Idiopathic pulmonary fibrosis (IPF) remains a debilitating, poor prognosis disease requiring a patient-centered approach.
To explore the pulmonologist's perspective on physician-patient communication.
A faculty of psychologists and pulmonologists organized a training course consisting of two workshops 12 months apart. Self-assessment questionnaires (pre- and post-course), role play (RP) simulations (during both workshops) and clinical consultation observations followed by semi-structured interviews (during the 12 months) were employed to evaluate the pulmonologists' knowledge of patient-centered medicine and communication/relational skills (questionnaires), their communication style (RP) and possible communication/relational difficulties (semi-structured interviews).
Twenty-three pulmonologists attended the first workshop and 14 the second one; 10 attended both. The questionnaires revealed the interest in patient-centered medicine and communication but also the need for deeper knowledge and improved skills. From the RP sessions performed during the first workshop, a disease-oriented approach emerged; notably, after the training, some improvements suggested a more patient-centered approach, e.g., a more frequent exploration of the patient agenda. Finally, the semi-structured interviews allowed to identify the low patients' cultural level and the poor general knowledge of IPF among the barriers hampering an effective communication with the clinician, who, however, is responsible for overcoming these obstacles.
Despite the overall disease-prone approach to IPF patients, there was room for improvement through adequate training, which, in practice, may ameliorate communication and drive towards patient-centeredness. Exploring the pulmonologists' needs may help tailoring training interventions. Raising awareness on these topics is crucial to ensure IPF patients optimal care.
特发性肺纤维化（IPF）仍然是一种使人衰弱、预后不良的疾病，需要以患者为中心的治疗方法。
探讨肺科医生对医患沟通的看法。
一个由心理学家和肺科医生组成的团队组织了一个培训课程，该课程由两个相隔12个月的工作坊组成。采用自我评估问卷（课程前后）、角色扮演（RP）模拟（在两个工作坊期间）以及临床会诊观察并随后进行半结构化访谈（在12个月期间）来评估肺科医生以患者为中心的医学知识和沟通/关系技能（问卷）、他们的沟通风格（RP）以及可能存在的沟通/关系困难（半结构化访谈）。
23名肺科医生参加了第一个工作坊，14名参加了第二个工作坊；10名参加了两个工作坊。问卷显示了对以患者为中心的医学和沟通的兴趣，但也表明需要更深入的知识和提高技能。从第一个工作坊期间进行的RP环节中，出现了一种以疾病为导向的方法；值得注意的是，培训后，一些改进表明采用了更以患者为中心的方法，例如更频繁地探讨患者议程。最后，半结构化访谈能够确定患者文化水平低以及对IPF的一般知识了解不足是阻碍与临床医生有效沟通的障碍，然而，临床医生有责任克服这些障碍。
尽管对IPF患者总体上倾向于采用以疾病为中心的方法，但通过适当的培训仍有改进空间，在实践中，这可能会改善沟通并推动以患者为中心。探索肺科医生的需求可能有助于定制培训干预措施。提高对这些主题的认识对于确保IPF患者获得最佳护理至关重要。
