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与患者沟通:外科医生对自身技能及培训需求的看法。

Communicating with patients: surgeons' perceptions of their skills and need for training.

作者信息

Girgis A, Sanson-Fisher R W, McCarthy W H

机构信息

NSW Cancer Council Cancer Education Research Program, Newcastle, New South Wales, Australia.

出版信息

Aust N Z J Surg. 1997 Nov;67(11):775-80. doi: 10.1111/j.1445-2197.1997.tb04578.x.

Abstract

BACKGROUND

This study assessed surgeons' current perceived level of competence in a number of interactional skills, their perceptions of the need for training and assessment in interactional skills, and their perceptions of the appropriateness of the format and content of two existing communication skills training packages.

METHODS

Of 267 surgeons who were sent the survey, 63% (n = 143) of eligible respondents completed and returned it.

RESULTS

More than three-quarters of the sample identified the following skills as being important or very important in being a good surgeon: breaking bad news; preparing patients for surgical procedures; educating patients about their diagnosis and treatment, and increasing the likelihood that they will remember what they have been told; detecting anxiety and depression in patients, encouraging patients to express these and listening to their anxieties. More than half the sample felt at least competent at seven of the 10 interactional skills, but almost one-third of the sample reported being 'not or not at all competent' at increasing patients' ability to remember what they have been told and at encouraging patients to express anxieties about their condition, and a further 13.3% reported a lack of competence at breaking bad news to patients about their diagnosis/prognosis. A higher proportion reported a lack of competence in providing bereavement counselling (59.6%), and gaining consent for organ donation (56.6%) and for autopsy (48.9%). The majority rated different aspects of the two communication skills training packages as either 'good' or 'excellent'.

CONCLUSIONS

The survey identified a number of communication skills which are perceived by surgeons to be important and to require formal training and assessment.

摘要

背景

本研究评估了外科医生当前对一系列互动技能的感知能力水平、他们对互动技能培训和评估需求的看法,以及他们对两个现有沟通技能培训包的形式和内容适当性的看法。

方法

在267名收到调查问卷的外科医生中,63%(n = 143)符合条件的受访者完成并返回了问卷。

结果

超过四分之三的样本认为以下技能对于成为一名优秀外科医生很重要或非常重要:传达坏消息;让患者为手术做好准备;对患者进行诊断和治疗方面的教育,并增加他们记住所告知内容的可能性;发现患者的焦虑和抑郁情绪,鼓励患者表达这些情绪并倾听他们的焦虑。超过一半的样本认为自己在10项互动技能中的7项上至少具备一定能力,但近三分之一的样本表示在提高患者记住所告知内容的能力以及鼓励患者表达对自身病情的焦虑方面“不具备或完全不具备能力”,另有13.3%的样本表示在向患者传达关于其诊断/预后的坏消息方面缺乏能力。更高比例的样本表示在提供丧亲辅导(59.6%)、获得器官捐赠同意(56.6%)和尸检同意(48.9%)方面缺乏能力。大多数人对两个沟通技能培训包的不同方面评价为“好”或“优秀”。

结论

该调查确定了一些外科医生认为重要且需要接受正规培训和评估的沟通技能。

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