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确认-规范化-伙伴(ANP)框架:一种用于肿瘤护理人员的新型共情沟通工具。

The Acknowledge-Normalize-Partner (ANP) Framework: A novel empathic communication tool for oncology nurses.

作者信息

Kramer Dana, Chow Kimberly, Davis Mary Elizabeth, Nelson Judith E, Anderson Kelley, Okpako Molly, Bernal Camila, Malisse Catherine E, Goldberg Jessica I

机构信息

Supportive Care Service, Memorial Sloan Kettering Cancer Center, New York, NY.

Department of Evidence-Based Nursing, Memorial Sloan Kettering Cancer Center, New York, NY.

出版信息

Palliat Support Care. 2023 Feb;21(1):12-19. doi: 10.1017/S1478951522000086.

Abstract

OBJECTIVE

To describe the development and implementation of a novel tool designed to enhance nurse-patient communication in a major academic cancer center, which nurses can learn quickly, incorporate into their primary palliative care practice, and broadly disseminate in order to improve the patient experience.

METHOD

An evidence-based empathic communication tool and educational program were designed to provide essential skills to oncology nurses in having discussions with patients about their personal values. Evaluation included nurse focus groups, pre- and post-course evaluations and interviews, and patient questionnaires.

RESULTS

Nurses were satisfied with the educational program and found the communication tool effective in a variety of clinical situations including discussions about personal values. Patients reported increased occurrences of these discussions when nurses utilized the framework (97% vs. 58%, < 0.0001) and a higher quality of clinician communication (mean [SD] from 0 = very worst to 10 = very best: 7.18 [2.3] vs. 5.04 [2.9], = 0.001).

SIGNIFICANCE OF RESULTS

Skilled, empathic communication is an essential component of high-quality primary palliative care. Oncology nurses are well suited to lead communication and provide this care as part of an interprofessional team. The training and tool described here are targeted and efficient, and prepare nurses to respond skillfully to emotion while facilitating important discussions about patient values.

摘要

目的

描述一种旨在加强一家大型学术癌症中心护士与患者沟通的新型工具的开发与实施情况,该工具护士能够快速学会,融入其初级姑息治疗实践,并广泛传播以改善患者体验。

方法

设计了一种基于证据的共情沟通工具和教育项目,为肿瘤护士提供与患者讨论其个人价值观时所需的基本技能。评估包括护士焦点小组、课程前后评估与访谈以及患者问卷调查。

结果

护士对教育项目感到满意,并发现该沟通工具在包括个人价值观讨论在内的各种临床情况下均有效。当护士使用该框架时,患者报告此类讨论的发生率有所增加(97%对58%,P<0.0001),且临床医生沟通质量更高(平均[标准差],从0=非常差到10=非常好:7.18[2.3]对5.04[2.9],P=0.001)。

结果的意义

熟练、共情的沟通是高质量初级姑息治疗的重要组成部分。肿瘤护士非常适合引领沟通并作为跨专业团队的一部分提供此类护理。此处描述的培训和工具具有针对性且高效,使护士能够在促进有关患者价值观的重要讨论时巧妙应对情感问题。

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