Considerations when communicating with awake patients undergoing image-guided neuro-interventions

The authors empirically evaluated the context of intra-procedural physician-patient communication during imaging-guided procedures in a radiology/neuroradiology interventional clinical framework. Different intra-procedural communicative scenarios are reported.They conclude that the quality of intra-procedural physician-patient communication should be considered an important element of individual and team ethical and professional behaviour, able to strongly influence the therapeutic alliance. As for the whole medical communication strategy, an approach which takes into account the psychological and cultural background of the individual patient is preferred.     

Effects of Communication Skills Training on Parents and Young Adolescents From Extreme Family Types

PROBLEM What were the effects of a communication skills training intervention among a sample of young adolescents and parents who scored in the “extreme” range of the Circumplex Model of Family Systems? METHODS Thirty‐seven young adolescents and a parent (intervention group) participated in communication skills training 2 hours/week for 6 weeks. Their responses on measures of satisfaction with the family system and perceptions of communication were compared with those of 47 young adolescents and a parent who scored in the extreme range but did not participate in the training (control group). FINDINGS Fathers and young adolescents demonstrated no change as a result of the program. Mothers who participated in skills training perceived communication with their young adolescent as more open than control mothers, but became increasingly dissatisfied with the family system. CONCLUSION This universal, community‐based, family‐focused intervention may not be indicated for extreme families.     

改善医护人员与交流障碍患者之间的交流

目的探讨如何改善交流障碍患者与其护理人员之间的交流。方法在长期护理机构（L-TCFs）中对健康护理人员（HCPs）进行交流培训和使用交流工具箱,设立试验组和对照组用于评价交流培训和工具箱的有效性。结果和结论培训及工具箱并没有显著效果。但某些措施对交流有益,特别是给听力损伤患者增加辅助用具。此外,L-TCFs的本质决定了要做到成功有效的交流会遇到机构设置等方面造成的障碍,这一点在解释研究结果时需予以考虑。本领域需要更多的研究。     

治疗性沟通概念的模态逻辑分析与应用

为促进高等护理教育者和临床护士对治疗性沟通概念形成较为科学的认识和应用，在综合现有护理专业各种教材对“治疗性沟通”概念多种描述的前提下，尝试从广义模态逻辑的角度对治疗性沟通概念进行时间逻辑、认知逻辑、道义逻辑的分析；并应用逻辑学方法提出治疗性沟通的临近“属”为医疗护理工作中的护患沟通活动；其“种差”，即治疗性沟通与一般性沟通和评估性沟通的区别，主要表现在沟通的目的、对象、形式、内容、过程、时间与空间等方面。     

评估性交谈概念的模态逻辑分析

作为一门护理与人文学科交叉的课程,在护理专业有关人际沟通内容的教材中,评估性交谈概念多有分歧。如果从逻辑学角度进行探析,评估性交谈应符合广义模态的时间逻辑、认知逻辑、道义逻辑。医疗护理工作中的护患沟通是评估性交谈的临近属概念,在明确一般性沟通、治疗性沟通与评估性交谈的区别或种差之后,可较准确地定义并应用评估性交谈的概念。     

护患沟通技巧现况及研究进展

阐述了护理人员对护患沟通的认知状况 ,以及促进护患沟通的条件。     

护士与老年科患者有效沟通的护理体会

本文通过总结护士与老年患者进行一般性沟通和治疗性沟通的临床护理经验,提出改善临床护患沟通的重要性和意义,旨在增进老年病房护士的临床沟通技巧,适应不断增长的老年患者服务需求,提高老年病房护理质量。     

临床实习护生人际沟通能力调查分析

目的：调查临床实习护生人际沟通能力现状,为护理教育教学改革提供参考依据。方法：应用沟通动机量表、沟通知识量表、沟通技能量表和人际沟通满意度量表对新乡地区三级综合医院临床实习护生240人进行问卷调查。结果：临床实习护生人际沟通能力整体水平一般,其中沟通技巧得分相对较高,其次是沟通知识和沟通动机,沟通满意度得分最低。结论：应根据护生人际沟通能力现状及其影响因素,进行有针对性的教学改革,提高护生沟通能力。     

Communication Training and Code Status Conversation Patterns Reported by Emergency Clinicians

ContextDuring acute health decompensations for seriously ill patients, emergency clinicians often determine the intensity end-of-life care. Little is known about how emergency clinicians conduct these conversations, especially among those who have received serious illness communication training.ObjectivesTo determine the self-reported practice patterns of code status conversations by emergency clinicians with and without serious illness communication training.MethodsA cross-sectional survey was conducted among emergency clinicians with and without a recent evidence-based, serious illness communication training tailored for emergency clinicians. Emergency clinicians were included from two academic medical centers. A five-point Likert scale (“very unlikely” to “very likely” to ask) was used to assess the self-reported likelihood of asking about patients’ preferences for medical procedures and patients’ values and goals.ResultsAmong 161 respondents (71% response rate), 77 (48%) received the training. A total of 70% of emergency clinicians reported asking about procedure-based questions, and only 38% reported asking about patient's values regarding end-of-life care. For value-based questions, statistically significant differences were observed between emergency clinicians who underwent the training and those who did not in four of the seven questions asked (e.g., the higher odds of exploring the patient's life priorities [adjusted OR = 4.34, 95% CI = 1.95–9.65, P-value < 0.001]). No difference was observed in the self-reported rates of all procedure-based questions between the two groups.ConclusionMost emergency clinicians reported asking about procedure-based questions, and some asked about patient's value-based questions. Clinicians with recent serious illness communication training may ask more about some values and priorities.     

中文修订版痴呆患者功能性沟通评价分量表的信效度检验

目的汉化、修订痴呆患者功能性沟通评价分量表,检验其信效度。方法通过系统的翻译、回译、Delphi专家咨询对英文版痴呆患者功能性沟通评价分量表进行汉化、修订,确定中文版功能性沟通评价量表的条目和内容,对128例老年期痴呆患者进行信、效度测量。结果量表的内容效度指数为0.905,探索性因素分析提取的简单社交沟通和表达需要2个公因子,联合解释变异量为53.04%;总量表的Cronbach'sα系数为0.930,2个维度的Cronbach'sα系数分别为0.922、0.797,重测信度为0.839,评定者间信度为0.606。结论修订后的中文版痴呆患者功能性沟通评价分量表具有较好的信度与效度,可用于老年期痴呆患者沟通能力的评估和研究。     

Improving verbal communication in critical care medicine

Human errors are the most common reason for planes to crash, and of all human errors, suboptimal communication is the number 1 issue. Mounting evidence suggests the same for errors during short-term medical care. Strong verbal communication skills are key whether for establishing a shared mental model, coordinating tasks, centralizing the flow of information, or stabilizing emotions. However, in contrast to aerospace, most medical curricula rarely address communication norms during impending crises. Therefore, this article offers practical strategies borrowed from aviation and applied to critical care medicine. These crisis communication strategies include “flying by voice,” the need to combat “mitigating language,” the uses of “graded assertiveness” and “5-step advocacy,” and the potential role of Situation, Background, Assessment, and Recommendation communication. We also outline the “step-back method,” the concept of communication “below ten thousand feet,” the impetus behind “closed-loop communication,” and the closely related “repeat-back method.” The goal is for critical care practitioners to develop a “verbal dexterity” to match their procedural dexterity and factual expertise.     

刍议护理语言的应用及作用

从临床护理语言在疾病康复中的作用出发 ,探讨了护士的社会角色、融洽护患关系等问题。提出临床护理语言是一个广义的概念 ,护患沟通中语言交流与非语言交流同等重要 ,是影响病人身体康复的重要社会因素。     

SWITCH for Safety: Perioperative Hand-off Tools

Communication breakdown is the leading cause of reported sentinel events in the perioperative setting. Barriers to optimal communication include noise, stress, multitasking, and rapid turnover between procedures. AORN has identified communication during personnel changes (ie, hand offs) as a point of vulnerability for the surgical patient. A standardized hand-off method provides an opportunity for personnel to ask and answer questions and should be available in the perioperative setting. At one facility, the standardization of hand-off reporting resulted in the development of new hand-off tools specific to the perioperative environment. A standardized reporting method enabled health care providers to address communication barriers and to maintain their focus on the patient during critical moments (eg, shift changes), thereby improving patient safety.     

基于微视频法的"爱的语言"沟通培训在产科护士中的应用效果

目的验证基于微视频法的“爱的语言”沟通培训在产科护士沟通能力培训中的效果。方法2020年3-12月,便利抽样选取丽水市两所医院产科120名护士作为研究对象,根据研究对象所在医院进行分组,观察组采用基于微视频法的“爱的语言”沟通方法,对照组采用常规护患沟通培训,比较两组护士沟通能力、护士培训满意度以及住院患者投诉率。结果观察组护士沟通能力及培训满意度均优于对照组(P<0.05),观察组住院患者投诉率低于对照组(P<0.05)。结论采用基于微视频法的“爱的语言”沟通培训有利于提升产科护士沟通能力及培训满意度,降低投诉率,改善护患关系。     

喉部手术后失音患者的沟通训练

目的 :探讨运用伯洛的沟通理论及沟通过程 5项要素与喉部手术后失音患者进行有效沟通的模式。方法 :因患咽喉疾患而致一段时间失音的患者 10 2例 ,分为 2组 ,进行身心需求问卷调查并运用图片卡交流 ;训练组患者同时进行特定的沟通手段及术前适应行为训练 ,应用图片卡、自编手语、写字板 3种方法进行护患沟通。结果 :2组患者在与护士进行有效沟通的领会程度上差异存在显著性 (P <0 .0 5 )。结论 :完善沟通过程 5项要素是与喉部手术后失音患者有效沟通的关键 ,适应行为训练是达到护患沟通的必要手段。