Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
Natl Med J India. 2023 Sep-Oct;36(5):320-322. doi: 10.25259/NMJI_950_2022.
Background In general surgery, a clinician is commonly required to break bad news. However, training in communication is not a part of the formal curriculum either in medical school or in surgical residency and there is a paucity of data on awareness of the SPIKES (Setting up the interview, Perception, Invitation, Knowledge sharing, Emotion, Strategy and Summary) protocol among practising surgeons and residents in India. Methods We did a cross-sectional study in the Department of General Surgery at our institution. Junior residents were invited to take part in a one-on-one interview. Descriptive statistics were used to describe the findings of the study. Comparison for categorical data was done using Fisher exact test or chi-square test (whichever was applicable). Results A total of 82 residents with mean (SD) age of 27 (2.5) years (range 23-37 years) participated in the study. Only 31 (37.8%) had ever received training for breaking bad news, though 80 (97.6%) had broken bad news at least once. Twenty-one (26.3%) participants had a bad experience while breaking bad news. Seventy-seven (93.9%) participants felt the need for training in breaking bad news and 76 of them were willing to attend the same. Although the complete SPIKES protocol was followed only by 25 (31.3%) residents, 46 (56.1%) felt that it was practically possible to follow the SPIKES protocol. Conclusion Resident doctors in general surgery face situations of breaking bad news and adherence to the SPIKES protocol is poor. Formal training at every level may enhance their communication skills and enable better healthcare delivery.
背景 在普通外科中，临床医生通常需要传达坏消息。然而，无论是在医学院还是在外科住院医师培训中，沟通培训都不是正规课程的一部分，而且关于印度执业外科医生和住院医师对 SPIKES（访谈准备、感知、邀请、知识共享、情感、策略和总结）方案的认识的数据很少。
方法 我们在我们的机构的普通外科系进行了一项横断面研究。邀请初级住院医师参加一对一访谈。使用描述性统计来描述研究结果。对于分类数据，使用 Fisher 精确检验或卡方检验（适用的）进行比较。
结果 共有 82 名平均（SD）年龄为 27（2.5）岁（范围 23-37 岁）的住院医师参加了研究。尽管 80（97.6%）人至少有过一次传达坏消息的经历，但只有 31（37.8%）人接受过传达坏消息的培训。21（26.3%）名参与者在传达坏消息时经历了糟糕的体验。77（93.9%）名参与者认为需要接受传达坏消息的培训，其中 76 人愿意参加。尽管只有 25（31.3%）名住院医师完全遵循 SPIKES 方案，但 46（56.1%）人认为实际上可以遵循 SPIKES 方案。
结论 普通外科住院医师面临传达坏消息的情况，并且对 SPIKES 方案的遵循情况较差。在各个层面进行正式培训可以提高他们的沟通技巧，并能够更好地提供医疗保健服务。
