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一项纳入共享决策在线技能的高级护理计划培训项目评估:一项干预前与干预后对比研究。

Evaluation of an Advanced Care Planning Training Program Incorporating Online Skills in Shared Decision Making: A Preintervention and Postintervention Comparative Study.

作者信息

Goto Yuko, Miura Hisayuki

机构信息

Department of Home Care and Regional Liaison Promotion, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Aichi, Japan.

出版信息

Healthcare (Basel). 2023 May 8;11(9):1356. doi: 10.3390/healthcare11091356.

Abstract

AIM

This study evaluated an advanced care planning (ACP) training program incorporating online skills in shared decision making (SDM).

METHOD

The New World Kirkpatrick Model was employed to assess the efficacy of the training program at four levels: reaction, learning, behavior, and results. Reaction measured the participants' satisfaction and difficulty with the training program alongside the status of support received from workplaces engaging in ACP. Learning evaluated the changes in SDM skills. Behavior assessed the changes in the relationship between patients and healthcare professionals when the latter were involved in the SDM process. Results evaluated whether the participants were willing to participate in ACP educational programs as a facilitator and whether their motivation for continuous learning changed through throughout the training program. The relationships among patients, healthcare providers, and third-party roles were analyzed in SDM role-playing via structural equation modeling (SEM).

RESULTS

Between September 2020 and June 2022, 145 multidisciplinary participants completed the entirety of the training program. The most common responses to the training were "satisfied", "slightly difficult", and "I received some support from my workplace". The SDM skills significantly improved from the first to the third workshop, evaluated using the Wilcoxon rank-sum test. In the first workshop, SDM was primarily performed by healthcare providers; however, in the third workshop, patient-centered SDM was adopted. Of the participants who completed the program, 63% intended to participate in future ACP educational programs as ACP education facilitators.

CONCLUSION

This study ascertained the validity of this training.

摘要

目的

本研究评估了一个纳入在线共同决策(SDM)技能的高级护理计划(ACP)培训项目。

方法

采用新世界柯克帕特里克模型在四个层面评估培训项目的效果:反应、学习、行为和结果。反应层面测量参与者对培训项目的满意度和难度,以及从参与ACP的工作场所获得的支持情况。学习层面评估SDM技能的变化。行为层面评估医疗保健专业人员参与SDM过程时患者与医疗保健专业人员之间关系的变化。结果层面评估参与者是否愿意作为促进者参与ACP教育项目,以及他们在整个培训项目中的持续学习动机是否发生变化。通过结构方程模型(SEM)在SDM角色扮演中分析患者、医疗保健提供者和第三方角色之间的关系。

结果

在2020年9月至2022年6月期间,145名多学科参与者完成了整个培训项目。对培训最常见的反馈是“满意”、“有点难”和“我从工作场所得到了一些支持”。使用威尔科克森秩和检验评估,从第一次研讨会到第三次研讨会,SDM技能有显著提高。在第一次研讨会中,SDM主要由医疗保健提供者进行;然而,在第三次研讨会中,采用了以患者为中心的SDM。完成该项目的参与者中,63%打算作为ACP教育促进者参与未来的ACP教育项目。

结论

本研究确定了该培训的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed26/10178132/3c1df8e922d6/healthcare-11-01356-g001.jpg

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