Rosa William E, Kastrinos Amanda, Banerjee Smita C, Acquaviva Kimberly, Alexander Koshy, McDarby Meghan, Behrens Mia, Parker Patricia A
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10017, USA.
University of Virginia School of Nursing, Charlottesville, VA 22903, USA.
Healthcare (Basel). 2024 Dec 19;12(24):2557. doi: 10.3390/healthcare12242557.
LGBTQ+ persons with cancer and their families consistently face discriminatory care. In addition, clinicians report inadequate population-specific knowledge and communication skills to effectively promote LGBTQ+ inclusion. To fill this gap, we designed a communication skills training based on extant literature; multidisciplinary perspectives; and patient, family, and clinician expert engagement. Training content comprised didactic information, including exemplar videos of communication strategies, and experiential learning roleplay opportunities with standardized patient and family member actors. Two training sessions were conducted virtually with invited multidisciplinary clinicians using convenience sampling. Each training was followed by a one-hour, semi-structured focus group to solicit feedback on participants' experiences and recommendations for improvement. Focus group transcripts were thematically analyzed using a constant comparative approach. Two major themes were identified: key takeaways from the training and recommendations for improvement. Participants reported favorable learning experiences and believed the training would have a positive influence on future clinical interactions. We synthesized recommendations into five discrete pieces of feedback related to (1) the advanced level of training material; (2) diversity throughout the training; (3) complexity of family dynamics; and (4) recovery from communication mistakes; and (5) additional topics for future training. Based on feedback, corresponding changes for each item and a refined communication skills blueprint are provided. Our innovative training on inclusive cancer care for LGBTQ+ patients' families will provide both knowledge-based and experiential learning opportunities to advance clinicians' confidence in communicating empathically with members of diverse sexual orientation and gender identities. The training is poised for feasibility and efficacy testing.
患有癌症的 LGBTQ+ 群体及其家人一直面临着歧视性的医疗护理。此外,临床医生表示,他们缺乏针对特定人群的足够知识和沟通技巧,无法有效地促进对 LGBTQ+ 群体的包容。为了填补这一空白,我们根据现有文献、多学科观点以及患者、家属和临床医生专家的参与设计了一项沟通技巧培训。培训内容包括理论知识,如沟通策略的示例视频,以及与标准化患者和家庭成员演员进行的体验式学习角色扮演机会。通过便利抽样,以虚拟方式为受邀的多学科临床医生举办了两次培训课程。每次培训后都进行了一个小时的半结构化焦点小组讨论,以征求参与者对培训体验的反馈以及改进建议。使用持续比较法对焦点小组记录进行了主题分析。确定了两个主要主题:培训的关键收获和改进建议。参与者报告了良好的学习体验,并认为该培训将对未来的临床互动产生积极影响。我们将建议综合为五条不同的反馈,分别涉及:(1)培训材料的高级水平;(2)培训过程中的多样性;(3)家庭关系的复杂性;(4)从沟通失误中恢复;以及(5)未来培训的其他主题。根据反馈,针对每个项目提供了相应的更改以及完善后的沟通技巧蓝图。我们为 LGBTQ+ 患者家庭提供的关于包容性癌症护理的创新培训将提供基于知识和体验式学习的机会,以增强临床医生与不同性取向和性别认同的成员进行共情沟通的信心。该培训准备进行可行性和有效性测试。