Academic Unit of Primary Medical Care, University of Sheffield, Sheffield, UK.
Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK.
Patient Educ Couns. 2023 Oct;115:107870. doi: 10.1016/j.pec.2023.107870. Epub 2023 Jun 29.
To describe the teaching and delivery of an extended consultation model designed for clinicians to use with patients with persistent physical symptoms and functional disorders. The model is underpinned by current scientific knowledge about persistent physical symptoms and the communication problems that arise in dealing with them.
Process evaluation of training and delivery of the Recognition, Explanation, Action, Learning (REAL) model within the Multiple Symptoms Study 3: a randomised controlled trial of an extended-role GP "Symptoms Clinic". Evaluation used clinician and patient interviews and consultation transcripts.
7 GPs were trained in the intervention and 6 of them went on to deliver the REAL model in Symptoms Clinics either face-to-face or online. The Symptoms Clinic provided a set of 4 extended consultations to approximately 170 patients. Evaluation of training indicated that there was a considerable load in terms of new knowledge and skills. Evaluation of delivery found clinicians could adapt the model to individual patients while maintaining a high level of fidelity to its core components.
REAL is a teachable consultation model addressing specific clinical communication issues for people with persistent physical symptoms.
REAL enables clinicians to explain persistent physical symptoms in a beneficial way.
描述一种扩展咨询模式的教学和实施，该模式旨在供临床医生用于治疗持续存在身体症状和功能障碍的患者。该模式的基础是关于持续身体症状的当前科学知识，以及在处理这些症状时出现的沟通问题。
对多症状研究 3 中 REAL 模型（识别、解释、行动、学习）的培训和实施进行过程评估：这是一项针对扩展角色全科医生“症状诊所”的随机对照试验。评估使用了临床医生和患者的访谈以及咨询记录。
7 名全科医生接受了干预措施的培训，其中 6 名医生在面对面或在线的症状诊所中提供了 REAL 模型。症状诊所为大约 170 名患者提供了一系列 4 次扩展咨询。培训评估表明，新知识和技能的负担相当大。实施评估发现，临床医生可以根据个体患者的情况调整模型，同时保持其核心组件的高度保真度。
REAL 是一种可教授的咨询模式，针对持续身体症状患者的特定临床沟通问题。
REAL 使临床医生能够以有益的方式解释持续的身体症状。
