Bernardes Christina M, Lin Ivan, Birch Stephen, Meuter Renata, Claus Andrew, Bryant Matthew, Isua Jermaine, Gray Paul, Kluver Joseph P, Ekberg Stuart, Pratt Gregory
Aboriginal and Torres Strait Islander Health Research Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Western Australian Centre for Rural Health (WACRH), The University of Western Australia, Geraldton, Western Australia, Australia.
Public Health Pract (Oxf). 2021 Dec 11;3:100221. doi: 10.1016/j.puhip.2021.100221. eCollection 2022 Jun.
Ineffective communication between healthcare clinicians and Aboriginal and Torres Strait Islander patients with persistent pain is a significant barrier to optimal pain management. This manuscript is a study protocol and describes the development and evaluation methods of a tailored, culturally-informed training program, to improve clinicians' communication with patients.
This is a single-arm, multicentre (2 metropolitan and 1 regional persistent pain service) intervention feasibility study that will be evaluated using mixed methods.
A communication training program will be developed informed by qualitative interviews with key stakeholders, and adapt the patient-centred 'clinical yarning' framework for the Queensland context. Evaluation of the effectiveness of the training will involve the analysis of quantitative data collected at three study sites over a 12-month period. At the patient level, communication experience will be rated at differing times of the training rollout to reflect participants' experience of communication either prior to or following the treating clinician attending the communication training. At the clinician level, evaluation of the training program will be based on changes of ratings in the importance of training, knowledge, ability and confidence to communicate with Aboriginal and Torres Strait Islander patients; satisfaction, acceptance and relevance to their clinical practice. This study will be grounded in the needs and preferences of communication of Aboriginal and Torres Strait Islander people living with pain.
It is hypothesized that the patient-centred intervention will have immediate benefits for patients, improving patient experience of care. This research will focus on an area of unmet need in addressing persistent pain.
医疗保健临床医生与患有持续性疼痛的原住民及托雷斯海峡岛民患者之间的无效沟通是实现最佳疼痛管理的重大障碍。本手稿是一项研究方案，描述了一个量身定制的、具有文化针对性的培训项目的开发和评估方法，以改善临床医生与患者之间的沟通。
这是一项单组、多中心（2个大都市和1个地区持续性疼痛服务机构）的干预可行性研究，将采用混合方法进行评估。
通过对关键利益相关者的定性访谈来制定沟通培训项目，并根据昆士兰的情况调整以患者为以患者为中心的“临床交谈”框架。对培训效果的评估将涉及对在12个月期间从三个研究地点收集的定量数据进行分析。在患者层面，将在培训推广的不同时间对沟通体验进行评分，以反映参与者在治疗临床医生参加沟通培训之前或之后的沟通体验。在临床医生层面，对培训项目的评估将基于培训重要性、与原住民及托雷斯海峡岛民患者沟通的知识、能力和信心的评分变化；满意度、接受度以及与他们临床实践的相关性。本研究将基于患有疼痛的原住民及托雷斯海峡岛民的沟通需求和偏好。
假设以患者为中心的干预措施将立即给患者带来益处，改善患者的护理体验。本研究将聚焦于解决持续性疼痛方面未满足需求的领域。
