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以患者为中心的沟通视角:一项聚焦小组研究,调查护理专业人员的经验和需求。

Perspective on patient-centered communication: a focus group study investigating the experiences and needs of nursing professionals.

作者信息

Mielke Kendra, Frerichs Wiebke, Cöllen Katja, Lindig Anja, Härter Martin, Scholl Isabelle

机构信息

Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.

出版信息

BMC Nurs. 2024 Nov 12;23(1):822. doi: 10.1186/s12912-024-02487-7.

Abstract

BACKGROUND

Delivering high quality care tailored to patients' needs necessitate patient-centered communication. High physical and mental workload, as well as organizational barriers, contribute to challenges nurses face in patient-centered communication. Participation in a communication skills training can help nurses to improve their patient-centered communication skills. Thus, the aim of this study was to investigate the experiences of nursing professionals in patient-centered communication and delineate the requisite content for a communication skills training.

METHODS

We conducted focus group interviews with nursing professionals working at an academic medical center in Germany. The focus group interviews were audio-recorded and transcribed verbatim. Data analysis was performed using Kuckartz's qualitative content analysis.

RESULTS

31 nursing professionals from diverse medical disciplines (e.g., pediatrics, obstetrics, cardiology, neurology, oncology) participated in the study, unveiling a spectrum of communication experiences, including organizational and system-related challenges, constraints induced by the COVID-19 pandemic, management of personal emotions, and communication challenges with patients and relatives. They also identified aspects they experienced as beneficial for patient-centered communication (e.g., allocating sufficient time, being authentic, providing clear information). Furthermore, participants identified specific aspects, which should be included in a patient-centered communication skills training.

CONCLUSION

The findings suggests that not only nurses from oncology and intensive care, but also from other medical disciplines, experience significant communication challenges with patients and relatives. Applying patient-centered aspects of communication was considered beneficial for effective communication. The needs identified through participants' experiences (e.g., core communication skills and strategies, handling escalating situations, and discussing serious illness, death and dying) informed the development of a patient-centered communication skills training specifically tailored for nursing professionals across diverse medical disinclines in Germany.

摘要

背景

提供符合患者需求的高质量护理需要以患者为中心的沟通。高身心工作量以及组织障碍,导致护士在以患者为中心的沟通中面临挑战。参与沟通技能培训有助于护士提高以患者为中心的沟通技能。因此,本研究的目的是调查护理专业人员在以患者为中心的沟通方面的经验,并确定沟通技能培训所需的内容。

方法

我们对德国一家学术医疗中心的护理专业人员进行了焦点小组访谈。焦点小组访谈进行了录音,并逐字转录。使用库卡尔茨的定性内容分析法进行数据分析。

结果

来自不同医学学科(如儿科、产科、心脏病学、神经病学、肿瘤学)的31名护理专业人员参与了该研究,揭示了一系列沟通经验,包括与组织和系统相关的挑战、COVID-19大流行引发的限制、个人情绪管理以及与患者和亲属的沟通挑战。他们还确定了他们认为对以患者为中心的沟通有益的方面(如分配足够的时间、保持真诚、提供清晰的信息)。此外,参与者确定了应以患者为中心的沟通技能培训中应包含的具体方面。

结论

研究结果表明,不仅肿瘤学和重症监护领域的护士,其他医学学科的护士在与患者和亲属的沟通中也面临重大挑战。应用以患者为中心的沟通方式被认为对有效沟通有益。通过参与者的经验确定的需求(如核心沟通技能和策略、处理局势升级以及讨论严重疾病、死亡和临终问题)为专门为德国不同医学领域的护理专业人员量身定制的以患者为中心的沟通技能培训的开发提供了参考。

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