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促进药房工作人员关于非药物治疗药物转换的沟通:一种沟通培训的开发与测试

Facilitating pharmacy staff's conversations about non-medical medication switches: Development and testing of a communication training.

作者信息

Schackmann Laura, Heringa Mette, Wolters Majanne, Faber Adrianne, van Dijk Liset, Koster Ellen S, Vervloet Marcia

机构信息

Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology & -Economics, University of Groningen, the Netherlands.

SIR Institute for Pharmacy Practice and Policy, Leiden, the Netherlands.

出版信息

Res Social Adm Pharm. 2023 May;19(5):738-745. doi: 10.1016/j.sapharm.2023.01.014. Epub 2023 Jan 31.

Abstract

BACKGROUND

Non-medical medication switches, a change to another medicine or medication label not motivated by medical reasons, occur frequently. Switches often lead to negative patient emotions, such as confusion and anger. Pharmacy staff's communication, i.e. delivering the message and addressing patients' emotions is crucial, but experienced as difficult.

OBJECTIVE

To develop and test a communication training for the pharmacy team to facilitate medication switch conversations.

METHODS

A communication training was developed based on the 'breaking bad news model' and 'positive message framing' strategies, and incorporating needs and preferences from practice. The training consisted of an e-learning with theory and reflective exercises, a half-day live training session, and an online reflection session. The Kirkpatrick training evaluation model (levels one 'reaction' and two 'learning') was used to evaluate the training. Quantitative data were analyzed using descriptive statistics and interview data was transcribed verbatim and analyzed thematically.

RESULTS

Twelve pharmacists and 27 pharmacy technicians from 15 Dutch pharmacies participated in the training. According to Kirkpatrick's model level one, the major learning outcome was to give space to patients to express their emotions and/or concerns (e.g. more silences in the conversations). For level two, most participants valued practicing the conversations, role-playing, and receiving feedback. The majority of the participants indicated that they had sufficient tools and practice during the live training to apply the strategies in daily practice. A few participants still needed time and practice, or missed examples to apply the strategies.

CONCLUSION

The communication training based on the two strategies was well-received and participants felt well-equipped post-training. The take-away for participants was to give space to patients to express their emotions. Using these strategies and skills, pharmacy teams can tailor their medication counseling to patients' emotions and concerns during non-medical medication switches to better support patients in proper medication use.

摘要

背景

非医疗性药物转换,即并非出于医疗原因而更换为另一种药物或药物标签的情况经常发生。这种转换常常会引发患者的负面情绪,如困惑和愤怒。药房工作人员的沟通,即传达信息并处理患者的情绪,至关重要,但却被认为很困难。

目的

开发并测试一种针对药房团队的沟通培训,以促进药物转换相关的对话。

方法

基于“告知坏消息模型”和“积极信息构建”策略,并结合实践中的需求和偏好,开发了一种沟通培训。该培训包括一个包含理论和反思练习的电子学习课程、一个为期半天的现场培训课程以及一个在线反思课程。使用柯克帕特里克培训评估模型(一级“反应”和二级“学习”)对培训进行评估。定量数据采用描述性统计进行分析,访谈数据逐字转录并进行主题分析。

结果

来自荷兰15家药房的12名药剂师和27名药房技术人员参加了培训。根据柯克帕特里克模型的一级评估,主要的学习成果是给患者留出表达情绪和/或担忧的空间(例如对话中更多的沉默)。对于二级评估,大多数参与者重视对话练习、角色扮演和接受反馈。大多数参与者表示,他们在现场培训期间有足够的工具和练习来将这些策略应用于日常实践。一些参与者仍然需要时间和练习,或者缺少应用这些策略的示例。

结论

基于这两种策略的沟通培训受到好评,参与者在培训后感觉准备充分。参与者的收获是给患者留出表达情绪的空间。通过使用这些策略和技能,药房团队可以在非医疗性药物转换期间根据患者的情绪和担忧调整用药咨询,以更好地支持患者正确用药。

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