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在交付过程中改善临床推理和沟通:BRIEF-C工具的干预研究
Ghazwan Altabbaa1, Tanya Nathalie Beran2, Marcia Clark3
1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada galtabba@ucalgary.ca.
BMJ open quality
|May 3, 2024
概括
该BRIEF-C工具改善了医疗转让期间的诊断推理和沟通. 这种结构化的方法通过解决关键的沟通差距来增强患者的护理.
科学领域:
- 医学教育 医学教育
- 卫生沟通健康沟通
- 患者安全 患者安全
背景情况:
- 现有的移交工具缺乏理论基础和心理测量证据.
- 移交时的沟通故障会影响患者的护理.
- 在医学沟通中需要加强诊断推理.
研究的目的:
- 开发和评估BRIEF-C (背景,负责任的诊断,包括差异诊断,排除差异诊断,后续,沟通) 工具.
- 评估该工具对医疗转移期间诊断推理和沟通的影响.
- 提供理论上有根据,可靠和有效的沟通策略.
主要方法:
- 测试前测试后干预研究设计.
- 干预涉及一场关于BRIEF-C的教育会议,随后进行了为期2周的反实践期.
- 音频录制的临床交接被盲目的教师评分员用BRIEF-C框架转录和评分.
主要成果:
- 主要组件分析确定了两个BRIEF-C子尺度:诊断临床推理和沟通.
- 干预后,在诊断临床推理 (p<0.05,科恩d=0.63) 和沟通 (p<0.05,科恩d=0.83) 两方面都观察到显著的改善.
- 在两个子尺度 (克朗巴赫α 0.82 和 0.99) 中具有很高的物件间一致性.
结论:
- BRIEF-C工具在评估诊断推理和沟通方面表现出可靠性和有效性.
- 该工具有效地增强了医疗交付期间的沟通策略.
- 结果支持BRIEF-C作为一个有价值的工具,通过更好的移交来改善患者护理.
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