在RCT中嵌入有关共享决策的教育干预:确保能力和忠诚度
Amy B Zelenski1, Karlie Haug2, Kyle J Bushaw2
1Department of Medicine, University of Wisconsin, Madison, WI, USA.
PEC innovation
|February 13, 2024
概括
科临床医生成功地学习了最佳情况/最坏情况沟通干预措施,以便与患者讨论透析启动. 这项研究展示了一种实时评估临床试验中沟通干预的方法.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医学教育 医学教育
- 临床传播 临床沟通
背景情况:
- 临终性疾病患者的透析启动决定需要敏感的沟通.
- 有效的沟通策略对于末期病的共享决策至关重要.
- 最好的情况/最坏的情况沟通干预旨在改善这些讨论.
研究的目的:
- 评估科临床医生的培训成果,使用最佳情况/最坏情况沟通干预.
- 在随机临床试验中评估干预能力,忠诚度和坚持性.
- 描述这种干预措施在关于透析启动的讨论中的应用.
主要方法:
- 在十个地点招募了68名科医生,并随机分配到干预或对照组.
- 培训重点是最佳情况/最坏情况沟通干预,用于透析启动讨论.
- 使用完成的图形辅助工具从患者接触测量了忠实性和坚持性.
主要成果:
- 在36名训练有素的科医生中,有34人取得了干预能力.
- 在干预组中,图形辅助工具的回报率达到了73%.
- 干预忠实度得分表明,在整个研究过程中,完全遵守了元素.
结论:
- 最好的情况/最坏的情况沟通干预可以在随机临床试验中有效地教授临床医生.
- 本研究提供了一种战略,用于实时评估沟通干预的坚持.
- 成功实施支持改善患者与临床医生的关于透析和预后的讨论.
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