教会医学学生如何向患者传递不好的消息

目的：医生在日常工作中,经常需要向患者传达不好的消息。为了使医学学生在此领域获得指导和经验．笔者进行了两个标准的向患者传递不良消息的训练。方法：45名医学院校的高年级的学生参加讨论对于直肠癌或流产的诊断。12名无任何经验。结果：那些以前有经验的学生,在对流产患者的处理上,表现比无经验的学生要好得多。结论：本研究表明,对学生教授传递不良消息的技巧是很有效的。     

Meeting the obligation to communicate clinical trial results to study volunteers

Although the overwhelming majority of study volunteers want to receive information on the results of their participation in clinical trials, research suggests that most study volunteers never do. CISCRP - an independent nonprofit organization - in collaboration with Pfizer, conducted a study evaluating the feasibility and impact of a new process to inform study volunteers of the results of their clinical trials. Two process components were evaluated via surveys, focus groups, and interviews with volunteers and investigative site staff: a series of ongoing post-trial communications to set expectations for when trial results would be received; and routine development and delivery of the lay language trial results summary. The results of this assessment show that study volunteers and investigative site staff are extremely receptive to receiving clinical trial results and that the process of preparing and disseminating clinical trial results is feasible and generally easy to execute. The results also indicate that study volunteer comprehension of basic facts about their clinical trial pre- and post-test increased by as much as 65.6 percentage points, and suggest that this communication initiative may positively impact volunteer recruitment, retention and long-term trust in the clinical research enterprise.     

Meeting the obligation to communicate clinical trial results to study volunteers

Although the overwhelming majority of study volunteers want to receive information on the results of their participation in clinical trials, research suggests that most study volunteers never do. CISCRP – an independent nonprofit organization – in collaboration with Pfizer, conducted a study evaluating the feasibility and impact of a new process to inform study volunteers of the results of their clinical trials. Two process components were evaluated via surveys, focus groups, and interviews with volunteers and investigative site staff: a series of ongoing post-trial communications to set expectations for when trial results would be received; and routine development and delivery of the lay language trial results summary. The results of this assessment show that study volunteers and investigative site staff are extremely receptive to receiving clinical trial results and that the process of preparing and disseminating clinical trial results is feasible and generally easy to execute. The results also indicate that study volunteer comprehension of basic facts about their clinical trial pre- and post-test increased by as much as 65.6 percentage points, and suggest that this communication initiative may positively impact volunteer recruitment, retention and long-term trust in the clinical research enterprise.     

肢体语言沟通在儿科护理工作中的应用分析

目的:对肢体语言沟通在儿科护理工作中的应用效果进行分析。方法:选择儿科2011年1月—2012年12月收治的120例患儿作为研究对象,随机分为对照组和观察组,每组各60例。对照组采用常规护理,观察组在此基础上加强与患儿肢体语言沟通,对护理过程中两组患儿的医嘱依从性、接受度以及患儿及其家属的满意度进行调查,并对结果进行比较分析。结果:观察组在完全抵触、部分抵触和绝对接受方面明显优于对照组,并且观察组患儿及家属对护理过程表示满意和非常满意的人数明显多于对照组,差异具有统计学意义(P<0.05)。结论:在儿科护理工作中加强肢体语言沟通,能够有效改善患儿的医嘱依从性和接受度,同时也能提高患儿及家属对护理过程的满意度,对护理质量改进具有促进作用。     

A multidisciplinary process to determine, communicate, and manage an antibiotic formulary

This article describes a collaborate process developed by the Pharmacy & Therapeutics Committee to define, determine, communicate, and manage an effective antibiotic formulary. Multiple professional disciplines represented by the antibiotic subcommittee evaluated each classification of antibiotics and recommended a preferred drug(s) for each classification. Decisions were based on relative safety, efficacy, and cost with minimal duplication of therapeutic equivalent antibiotics. A therapeutic interchange policy was unnecessary because extensive communication measures developed by the committee proved effective. The strategy used strengthened pharmacist/physician working relationships. This process permitted rationality and understanding by the medical staff, which resulted in unanimous formulary acceptance.     

新形势下病案室如何与临床沟通

随着我国医疗体制改革的不断深入和社会走向现代化,前来病案室复印病案的患者越来越多,病案室医务人员的工作任务越来越繁琐,再加上2002年《医疗事故处理条例》的实施,病案的用途越来越广泛。由于每个人对病案复印的目的、用途不同,对病案的质量要求也有所不同。在当代社会,绝大多数患者前来复印病案是因为保险报销、伤残鉴定,而在保险报销及伤残鉴定的过程中,病案起主导作用。有时病案的问题影响患者保险报销不了或原本患者伤残已够评定标准而因病案问题导致伤残鉴定不够级,导致患者或患者家属有不良情绪,这时面对气急败坏的患者或患者家属,我们应积极与临床沟通,提高病案质量,避免医患纠纷,这是现代医院病案室的重中之重。病案室人员掌握沟通技巧化解医患矛盾,才能与病案复印患者及其家属建立一种互信关系,达到共赢目的。良好的与临床沟通,不仅提高了病案质量,也加强了院内各科室与病案室的联系。     

How to communicate bad news to caregivers of patients with amyotrophic lateral sclerosis: a human challenge

In patients with amyotrophic lateral sclerosis families require assistance especially when bad news needs to be faced. We developed a binary items talk protocol on various aspects of the disease at its late stages to be submitted to caregivers: it was also aimed at identifying the personality of the caregiver. The report was prepared as a 6-question score (0→10). Thirty-three subjects were identified. The caregivers’ ability to help the patient, the satisfaction after talk and level of comprehension were: 7.6, 7 and 6.4, respectively. The mean level of calm and confusion was 6 and 4.7, respectively. The average number of meetings was 2.33±1.1; 22% of caregivers needed only 1 meeting, 39% two and 39% >2. The average total time for the meetings was 54±26 min. A simple bad news communication protocol dedicated to caregivers of patients with amyotrophic lateral sclerosis may be used on a routine basis.     

Novel ways of using tobacco packaging to communicate health messages: Interviews with packaging and marketing experts

Background: Packaging is a powerful communications tool. In this study innovative ways in which cigarette packaging could potentially be used to communicate health messages, beyond the on-pack warnings and plain packaging, were explored. Methods: Face-to-face interviews were conducted with packaging and marketing experts (N?=?12) in the United Kingdom to explore novel ways of using the cigarette pack and cigarette to communicate with consumers: (1) Pack inserts, (2) A cigarette displaying a health warning, and (3) A pack playing an audio health message when opened. Participants were also asked to propose other ways, beyond those discussed, in which the pack could potentially be used to communicate health messages. Results: The on-cigarette warning was considered a powerful deterrent, thought to confront smokers, put off non-smokers, signal to youth that it is neither cool nor intelligent to smoke, and prolong the health message. Inserts were considered an appropriate supplement to the on-pack warnings, particularly if they featured gain-framed messages, and helpful for engaging smokers contemplating quitting. It was suggested that the pack with an audio health message may badger a regular smoker to the point of quitting, but the concern was that it was annoying and could lead smokers to decant their cigarettes into an alternative carrier. A number of other options for communicating with consumers were proposed. Conclusions: Pack inserts and cigarettes displaying health messages are two viable options available to regulators for supplementing the warnings on the outside of packs and thus extending health communication with consumers.     

Willingness to communicate about organ donation among migrant workers in mainland China:a cross-sectional questionnaire survey

Objective Voluntary organ donation is the sole legitimate source of deceased transplantable organs in China.Migrant workers have been major donors.The aim of this study was to examine willingness to communicate about organ donation and identify its predictors among Chinese migrant workers.Methods A total of 660 Chinese migrant workers were recruited into the study.Data were collected by the Chinese version of Organ Donation Attitude Scale,Death Attitude Profile-Revised (DAP-R),Self-Report Altruism Scale (SRA),Willingness to Communicate Sale (WTCS),and a socio-demographic data sheet.Results A total of 688 eligible migrant workers was approached and 660 workers completed the study with the response rate of 95.9％.Migrant workers reported moderate level of willingness to communicate about organ donation.The best-fit regression analysis revealed five variables that explained 32.6％ of the variance in willingness to communicate about organ donation.They were approval of organ donation,obstacle of organ donation,approach acceptance and death avoidance.Conclusion Migrant workers who had a stronger feeling about organ donation or death,and stronger altruism tendencies had a higher willingness to communicate about organ donation.Accordingly,the campaign strategy to promote family communication should enhance positive attitudes about donation,alleviate the fear of death and focus on the altruism element of donation behavior.