多发性硬化症神经病学家在预先护理计划对话中的沟通能力:一项多观察者研究
Andrea Giordano1,2, Ludovica De Panfilis3,4, Roberta Martina Zagarella5
1Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
PloS one
|March 12, 2026
概括
预先护理规划 (ACP) 培训提高了神经科医生在渐进性多发性硬化症 (PwPMS) 护理中的沟通技巧,得到了患者和其他重要人的高评价. 神经科医生表现出适度的共享决策能力,在这些关键的对话中有效地解决患者的情绪.
科学领域:
- 神经学 神经学
- 医学沟通 医学沟通
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在ConCure-SM干预中,为管理渐进性多发性硬化症 (PwPMS) 的医疗保健专业人员提供了预先护理规划 (ACP) 培训.
- 这项研究评估了完成了非洲国家和地区培训的神经病学家的沟通技巧.
研究的目的:
- 在ConCure-SM试验中评估接受预先护理规划 (ACP) 培训的神经病学家的沟通能力.
- 为了评估患者和护理人员对神经科医生沟通的看法,在ACP讨论期间.
- 分析神经病学家在多大程度上促进了情绪表达和共同决策在非洲和非洲的对话.
主要方法:
- 音频录制了神经科医生和患有渐进性多发性硬化症 (PwPMS) 的人之间18次预先护理计划 (ACP) 对话,有或没有重要他人 (SOs).
- 参与者和神经科医生使用沟通质量 (QOC) 问卷对沟通进行了评分.
- 独立观察员使用观察患者参与共享决策 (OPTION) 和维罗纳对情绪序列的编码定义 (VR-CoDES) 工具评估了对话.
主要成果:
- 患者 (PwPMS) 和重要的人 (SOs) 评价神经病学家的一般和终身沟通能力很高 (平均QOC分数为90.1-95.2).
- 神经学家评价自己的沟通能力较低 (平均QOC为69.5).
- 观察到适度的共享决策 (SDM) 能力 (平均OPTION得分为48.4),尽管高于之前的MS咨询研究. 神经科医生适应了大多数患者的情绪线索和担忧,包括那些用比喻表达的.
结论:
- 在ACP培训的神经科医生表现出高的沟通能力被患者和SO认为,尽管更多的批判性自我评估.
- 虽然SDM技能中等,但它们优于MS护理的基准.
- 在ACP的谈话中,可以有效地引起情绪,训练有素的神经科医生通常为患者提供足够的空间来表达这些情绪.
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