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传递坏消息:医学生的情感视角与应对策略

Delivering Bad News: Emotional Perspective and Coping Strategies of Medical Students.

作者信息

Sobczak Krzysztof, Trzciński Marcin, Kotłowska Agata, Lenkiewicz Julia, Lenkiewicz Oliwia, Przeniosło Julia, Plenikowski Jan

机构信息

Department of Sociology of Medicine & Social Pathology, Medical University of Gdansk, Gdansk, Poland.

Student Scientific Circle of Medical Communication, Medical University of Gdansk, Gdańsk, Poland.

出版信息

Psychol Res Behav Manag. 2023 Aug 7;16:3061-3074. doi: 10.2147/PRBM.S421995. eCollection 2023.

Abstract

PURPOSE

The aim of our study was to analyze students' emotional experiences and coping mechanisms regarding the situation of delivering bad news (DBN).

PATIENTS AND METHODS

291 fifth- and sixth-year students from 14 medical universities took part in our study. Their responses were analyzed from the perspective of their experience - whether the individuals received bad news, delivered bad news themselves, witnessed bad news being delivered, or had no experience at all. We used content analysis (CA) to examine the responses and analyzed classified variables using χ tests, logistic regression, and predictive modeling with multiple correspondence analysis (MCA).

RESULTS

Students who had experience as a deliverer were more likely to experience failure and guilt (p=0.005). Predictions of anxiety (59.3%), stress (41.9%), and sadness (33.7%) were the highest in the students with no DBN experience. These students were most likely to make statements suggesting lack of methods and strategies for coping with difficult emotions. Students, who were immersed in DBN experiences, more often expressed the need to talk about their emotions with an experienced doctor, a family member or a friend, and used those conversations as a coping strategy.

CONCLUSION

The most important aspects that influence the quality of delivering bad news are both communication skills and emotional context. Training regarding DBN should not only contain those two elements, but also consider the development of coping mechanisms.

摘要

目的

我们研究的目的是分析学生在传递坏消息(DBN)情况下的情感体验和应对机制。

患者与方法

来自14所医科大学的291名五年级和六年级学生参与了我们的研究。从他们的经历角度分析他们的回答——个人是否收到过坏消息、自己传递过坏消息、目睹过坏消息的传递,或者根本没有相关经历。我们使用内容分析(CA)来检查回答,并使用χ检验、逻辑回归和多重对应分析(MCA)的预测模型分析分类变量。

结果

有传递坏消息经历的学生更有可能经历失败和内疚(p = 0.005)。在没有DBN经历的学生中,焦虑(59.3%)、压力(41.9%)和悲伤(33.7%)的预测值最高。这些学生最有可能做出表明缺乏应对困难情绪方法和策略的陈述。沉浸在DBN经历中的学生更常表示需要与有经验的医生、家庭成员或朋友谈论他们的情绪,并将这些谈话作为一种应对策略。

结论

影响传递坏消息质量的最重要方面包括沟通技巧和情感背景。关于DBN的培训不仅应包含这两个要素,还应考虑应对机制的发展。

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