长度评估居民对共享决策,以患者为中心的沟通以及对不确定性的反应的看法
Anna M Kerr1, Charee M Thompson2, Claire A Stewart3
1Department of Primary Care, Ohio University, Dublin, OH, USA.
Journal of communication in healthcare
|May 22, 2025
概括
由于不确定性而感到焦虑的居民在整个培训过程中对以患者为中心的沟通和共享决策技能的信心较低. 解决不确定性是改善这些必要的医生与患者互动的关键.
科学领域:
- 医学教育 医学教育
- 在医疗保健领域的沟通
- 心理学在医学中的应用
背景情况:
- 管理不确定性对于以患者为中心的沟通 (PCC) 和共享决策 (SDM) 至关重要.
- 人们对居民对不确定性的反应如何影响他们参与PCC和SDM的能力知之甚少.
- 这项研究调查了居民自我感知的PCC和SDM技能以及他们对不确定性的反应之间的纵向关联.
研究的目的:
- 评估居民自我感知以患者为中心的沟通 (PCC) 和共享决策 (SDM) 技能以及他们对不确定性的反应之间的关系.
- 了解这些感知如何在整个住院培训过程中演变.
主要方法:
- 对两组儿科住院医生进行了为期三年的纵向调查.
- 居民每年自报PCC行为,SDM技能,不容忍不确定性,以及对不确定性的特定情境反应.
- 在第一年收集了100名居民的数据,第二年收集了61名居民的数据,第三年收集了53名居民的数据.
主要成果:
- 不确定性和不愿透露不确定性的焦虑在所有培训阶段都对SDM的认知产生了负面预测.
- 不确定性的焦虑也负面地预测了PCC信息相关的行为,但不是社会情感沟通.
- 对不良结果的担忧主要预测了信息提供;对不确定性的耐受性没有显著预测PCC或SDM.
结论:
- 对不确定性的负面反应较强的居民报告说,随着时间的推移,他们自我感知的PCC和SDM技能有所下降.
- 居住计划应包括培训,以使关于不确定性的讨论正常化.
- 培训应侧重于在不确定的临床情况下有效的PCC和SDM策略.
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