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共情沟通技巧培训以减少肺癌污名化:一项集群随机对照试验研究方案。

Empathic communication skills training to reduce lung cancer stigma: Study protocol of a cluster randomized control trial.

机构信息

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY 10017, USA.

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY 10017, USA.

出版信息

Contemp Clin Trials. 2024 Oct;145:107669. doi: 10.1016/j.cct.2024.107669. Epub 2024 Aug 23.

DOI:10.1016/j.cct.2024.107669
PMID:39182827
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11407099/
Abstract

BACKGROUND

Prior research demonstrates that nearly all (95 %) people with lung cancer (PwLC) report stigma, and approximately half (48 %) PwLC experience stigma during clinical encounters with oncology care providers (OCPs). When stigma is experienced in a medical context, it can have undesirable consequences including patients' delaying and underreporting of symptoms, misreporting of smoking behavior, and avoiding help-seeking such as psychosocial support and cessation counseling. Multi-level interventions are needed to prevent and mitigate lung cancer stigma. One promising intervention for reducing patient perception and experience of stigma is to train OCPs in responding empathically to patient emotions and promoting empathic communication within clinical encounters.

METHODS

This paper describes the study protocol for a cluster randomized trial comparing Usual Care (waitlist control group) with Empathic Communication Skills (ECS) training (intervention group). For this study, we will recruit 16 community oncology practice sites, 9-11 OCPs per site, and 6 PwLCs per OCP.

RESULTS

The goal of this trial is to investigate the effect of the ECS training on (a) OCP primary outcomes (communication and empathic skill uptake) and secondary outcomes (ECS training appraisal - relevance, novelty, clarity; self-efficacy, attitude towards communication with patients); and (b) patient-reported primary outcomes (lung cancer stigma), and secondary outcomes (perceived clinician empathy, satisfaction with OCP communication, psychological distress, social isolation, and appraisal of care).

CONCLUSION

Findings from this trial will advance understanding of the effectiveness of the ECS training intervention and inform future provider-level training interventions that may reduce lung cancer stigma and improve cancer care delivery.

CLINICALTRIALS

govIdentifier: NCT05456841.

摘要

背景

先前的研究表明,几乎所有(95%)肺癌患者(PwLC)都报告存在污名化问题,约有一半(48%)PwLC 在与肿瘤学护理提供者(OCPs)进行临床接触时经历过污名化。当污名化出现在医疗环境中时,可能会产生不良后果,包括患者延迟和漏报症状、错误报告吸烟行为以及避免寻求帮助,如社会心理支持和戒烟咨询。需要采取多层次的干预措施来预防和减轻肺癌污名化。一种有前途的干预措施是培训 OCPs 以同理心回应患者的情绪,并在临床接触中促进同理心沟通,从而减少患者对污名化的感知和体验。

方法

本文介绍了一项针对常规护理(候补对照组)与同理心沟通技能(ECS)培训(干预组)进行比较的集群随机试验的研究方案。在这项研究中,我们将招募 16 个社区肿瘤学实践场所,每个场所 9-11 名 OCPs,每名 OCP 招募 6 名 PwLC。

结果

该试验的目标是研究 ECS 培训对(a)OCP 主要结果(沟通和同理心技能采纳)和次要结果(ECS 培训评估-相关性、新颖性、清晰度;自我效能、与患者沟通的态度)的影响;以及(b)患者报告的主要结果(肺癌污名化)和次要结果(感知临床医生同理心、对 OCP 沟通的满意度、心理困扰、社会隔离和对护理的评价)的影响。

结论

该试验的结果将增进对 ECS 培训干预有效性的理解,并为未来可能减少肺癌污名化和改善癌症护理提供的提供者层面的培训干预提供信息。

临床试验

govIdentifier:NCT05456841。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/503b/11407099/3b36c3f800fa/nihms-2020450-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/503b/11407099/3b36c3f800fa/nihms-2020450-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/503b/11407099/3b36c3f800fa/nihms-2020450-f0001.jpg

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本文引用的文献

1
Getting ready for prime time: Recommended adaptations of an Empathic Communication Skills training intervention to reduce lung cancer stigma for a national multi-center trial.准备好迎接黄金时段:推荐对共情沟通技巧培训干预进行适应性调整,以减少全国多中心试验中肺癌污名化。
Transl Behav Med. 2023 Sep 28;13(10):804-808. doi: 10.1093/tbm/ibad048.
2
Oncology Care Provider Training in Empathic Communication Skills to Reduce Lung Cancer Stigma.肿瘤护理提供者同理心沟通技能培训以减少肺癌污名。
Chest. 2021 May;159(5):2040-2049. doi: 10.1016/j.chest.2020.11.024. Epub 2020 Dec 16.
3
Responding empathically to patients: a communication skills training module to reduce lung cancer stigma.
对患者做出共情回应:一个旨在减少肺癌污名化的沟通技巧培训模块。
Transl Behav Med. 2021 Mar 16;11(2):613-618. doi: 10.1093/tbm/ibaa011.
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Understanding lung cancer screening behaviour using path analysis.运用路径分析理解肺癌筛查行为。
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Lung cancer stigma and depression: Validation of the Lung Cancer Stigma Inventory.肺癌污名与抑郁:肺癌污名量表的验证。
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Multilevel Opportunities to Address Lung Cancer Stigma across the Cancer Control Continuum.多层面机会解决癌症控制连续体中的肺癌污名问题。
J Thorac Oncol. 2018 Aug;13(8):1062-1075. doi: 10.1016/j.jtho.2018.05.014. Epub 2018 May 23.
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Empathic Communication in Virtual Education for Nursing Students: I'm Sorry to Hear That.护理专业学生虚拟教育中的共情沟通:很遗憾听到这个消息。
Nurse Educ. 2017 Jan/Feb;42(1):18-22. doi: 10.1097/NNE.0000000000000308.
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Responding empathically to patients: Development, implementation, and evaluation of a communication skills training module for oncology nurses.对患者的共情回应:肿瘤护理人员沟通技能培训模块的开发、实施与评估
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