Parle M, Maguire P, Heaven C
CRC Psychological Medicine Group, Christie Hospital, Manchester, U.K.
Soc Sci Med. 1997 Jan;44(2):231-40. doi: 10.1016/s0277-9536(96)00148-7.
Health professionals such as doctors and nurses are in a key position to help reduce the high prevalence of affective disorders and psychological problems experienced by cancer patients. This role, however, is inhibited by ineffective communication practices which include the use of distancing strategies and avoidance by the health professional. A number of contributory factors such as skill deficits and anxiety about negative consequences for the patient and the health professional have been identified in previous research and brief problem-focused training workshops developed to address these factors with only limited success. Researchers in applied psychology have recommended that the development of training programmes and their evaluation are based upon approaches which take into account cognitive and affective factors as well as change in skills. The aim of this paper is to develop a conceptual model of communication behaviour in the cancer setting. The model aims to take account of the role that knowledge and skill deficits, self-efficacy and outcome expectancy beliefs and perceived support plays in the ability and willingness of health professionals to assess their patients' concerns. It has been applied to guide the development of a revised approach to brief, problem-focused workshops for health professionals. It also allows a systematic and multi-dimensional evaluation of training outcomes. Preliminary results indicate this is a promising area of communications research.
医生和护士等医疗专业人员在帮助降低癌症患者中情感障碍和心理问题的高患病率方面处于关键地位。然而,这一作用受到无效沟通行为的抑制,这些行为包括使用疏远策略以及医疗专业人员的回避。先前的研究已经确定了一些促成因素,如技能缺陷以及对患者和医疗专业人员负面后果的焦虑,并且已经开发了以问题为重点的简短培训工作坊来解决这些因素,但取得的成功有限。应用心理学领域的研究人员建议,培训项目的开发及其评估应基于考虑认知和情感因素以及技能变化的方法。本文的目的是建立一个癌症环境中沟通行为的概念模型。该模型旨在考虑知识和技能缺陷、自我效能感和结果期望信念以及感知支持在医疗专业人员评估患者担忧的能力和意愿中所起的作用。它已被应用于指导为医疗专业人员开发一种修订后的、以问题为重点的简短工作坊方法。它还允许对培训结果进行系统的多维度评估。初步结果表明,这是一个很有前景的沟通研究领域。