仅仅是培训就足够了吗? 严重疾病沟通培训与没有实施策略的比较
Samantha X Y Wang1, Rebecca Fong2, Felicia Hui3
1Division of Hospital Medicine, Department of Medicine, Stanford School of Medicine, Stanford, California, USA.
Journal of palliative medicine
|September 10, 2025
概括
实施支持显著改善了临床医生之间严重疾病对话 (SIC) 的采用和持续使用. 结构化的支持,不仅仅是沟通技能的培训,是有效的重病护理计划 (SICP) 集成的关键.
科学领域:
- 医疗教育 医学教育
- 改善医疗保健质量 改善医疗保健质量
- 抚慰性护理是一种缓解性护理.
背景情况:
- 单独的沟通技巧培训对严重疾病对话 (SIC) 的影响有限.
- 需要有结构的支持策略来加强SIC的采用和在临床实践中持续使用.
- 严重疾病护理计划 (SICP) 实施以应对这些挑战.
研究的目的:
- 评估SICP对SIC采用和持续使用的影响.
- 为了比较"仅培训"与"培训与实施支持"模式的有效性.
主要方法:
- 在单个学术中心对SIC文档频率的回顾性审查 (2020年10月 - 2023年5月).
- 两个干预组:仅培训和培训与实施支持 (包括患者识别,数据反,指导,激励).
- 临床医生按SIC文档频率 (从来没有,很少,偶尔,频繁) 和持续使用 (六个月的月度文档) 分类.
主要成果:
- 与"仅提供培训"相比",支持实施的培训"组的采用率显着更高,"从未使用者"较少 (57.6%对78.9%,p <0.01).
- 在实施支持组中观察到"罕见"",偶尔"和"频繁"用户的比例更高.
- 在"培训与实施支持"组中,持续使用显著增加 (9.4%对1.6%,p < 0.01).
结论:
- 实施支持策略对于加强初步采用和持续使用严重疾病对话至关重要.
- 除了沟通培训之外,整合结构化支持对于成功实施SICP至关重要.
- 这种方法可以提高关键患者-临床医生沟通的频率和一致性.
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