Kvæl Linda Aimée Hartford, Bye Asta, Bergland Astrid, Fromholt Olsen Cecilie
Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), University of Oslo, Institute of Health and Society, Faculty of Medicine, Oslo, Norway.
BMJ Open. 2025 Mar 25;15(3):e091143. doi: 10.1136/bmjopen-2024-091143.
This study aimed to investigate healthcare professionals' (HCPs') experiences with the simulation-based Four Habits Model (4HM) course programme and evaluate how they perceived the 4HM's immediate and persistent significance for practice within the intermediate care (IC) context.
A qualitative approach was combined with a survey design, structured within an exploratory sequential framework consisting of two phases: (1) focus group interviews with HCPs who had completed the course 2-4 weeks postcourse (n=11), and (2) a detailed questionnaire completed 4 months postcourse (n=14).
IC serves as a bridge in the patient pathway from hospital to home providing community-based rehabilitation. The 4HM is a well-established framework for improving clinical communication in healthcare. However, it has never been tested in IC. We conducted two 4HM courses in April 2023 at an IC institution in Norway's capital.
The study involved clinical HCPs (n=15) working in IC, participating in the 4HM courses, and consisted of seven nursing assistants, five nurses and three therapists.
The HCPs experienced the 4HM course to be important and useful for practice in the IC context. They perceived that the easy-to-use framework could be applied in many patient-HCP interactions, had the potential to frame the 'what matters to you' question and increase satisfaction among patients and relatives. The survey conducted after 4 months disclosed that participants believed they had acquired and applied new communication skills.
The 4HM provided a structured framework for interactions in the IC context, enhancing professionalism and streamlining daily tasks. Overall, the model fostered patient participation through improved communication skills. The findings could assist stakeholders, HCPs and IC service managers in developing educational programmes for HCPs to enhance communication skills and improve the quality of care for older patients in transitional care.
本研究旨在调查医疗保健专业人员（HCPs）参与基于模拟的“四习惯模型”（4HM）课程计划的体验，并评估他们如何看待4HM在中级护理（IC）环境中对实践的即时和持续重要性。
采用定性方法与调查设计相结合的方式，构建在一个探索性序列框架内，该框架由两个阶段组成：（1）对课程结束后2至4周完成课程的HCPs进行焦点小组访谈（n = 11），以及（2）课程结束4个月后完成的详细问卷（n = 14）。
IC在患者从医院到家庭的路径中起到桥梁作用，提供基于社区的康复服务。4HM是一个完善的改善医疗保健中临床沟通的框架。然而，它从未在IC中进行过测试。2023年4月，我们在挪威首都的一个IC机构举办了两期4HM课程。
该研究涉及在IC工作、参加4HM课程的临床HCPs（n = 15），包括七名护理助理、五名护士和三名治疗师。
HCPs认为4HM课程对IC环境中的实践很重要且有用。他们认为这个易于使用的框架可以应用于许多患者与HCP的互动中，有可能构建“对你来说重要的是什么”这个问题，并提高患者和亲属的满意度。4个月后进行的调查显示，参与者认为他们已经获得并应用了新的沟通技巧。
4HM为IC环境中的互动提供了一个结构化框架，提高了专业性并简化了日常任务。总体而言，该模型通过提高沟通技巧促进了患者参与。这些发现可以帮助利益相关者、HCPs和IC服务管理人员为HCPs制定教育计划，以提高沟通技巧并改善过渡护理中老年患者的护理质量。
