Definitions and use of the teach-back method in healthcare consultations with patients: A systematic review and thematic synthesis

ObjectiveTo review and synthesise definitions of the teach-back method in the literature. The second aim is to synthesise the barriers, facilitators and perceptions of teach-back use in healthcare consultations with patients.MethodsA systematic review and thematic synthesis following Braun and Clarke’s method.ResultsThe primary search found 1429 citations and the secondary search added 221 citations. Screening identified 66 citations eligible for data extraction. We contrasted and synthesised operational definitions of the teach-back method. The synthesis generated seven themes related to healthcare provider (HCP) and patient perceptions of teach-back (effectiveness, stigma and time-related perceptions), the universal application of teach-back, patient health outcomes and healthcare provider training.DiscussionOperational definitions of the teach-back method varied in the literature and contained implied steps. HCPs and patient perceptions of teach-back operated as both enablers and barriers to its use. HCPs training programs for the teach-back method were identified as beneficial for altering HCPs perceptions about the method and increased its use with patients.Practice implicationsStandardising operational definitions of the teach-back method can support replicability of research and enhance HCPs communication skills training programs. HCPs training on teach-back use can support the increased use of the technique with broader patient populations.     

叙事视频联合回授法对专职陪护人员预防误吸知信行水平的影响

目的探讨叙事视频联合回授法对专职陪护人员预防误吸知信行水平的影响。方法采用便利抽样法选取某三级甲等医院专职陪护人员为研究对象,2018年7—8月将89名专职陪护人员设为对照组,2018年10—11月将76名专职陪护人员设为观察组。对照组采用常规健康宣教,观察组在对照组的基础上采用叙事视频联合回授法进行误吸预防的宣教。比较两组专职陪护人员预防误吸的知识、态度、行为得分。结果观察组的知识得分为44(37,49)分,高于对照组的39(31,45.5)分,差异有统计学意义(Z=-3.463,P<0.01)。观察组的态度得分为50(45,54)分,高于对照组的44(44,52)分,差异有统计学意义(Z=-3.566,P<0.01)。观察组的行为得分为47(41,51)分,高于对照组的41(35,53)分,差异有统计学意义(Z=-2.462,P<0.05)。结论叙事视频联合回授法是一种有效的健康宣教形式,有助于提高专职陪护人员预防误吸的知识、态度、行为水平及临床照顾能力。     

对家庭主要照顾者实施回授法干预对老年桡骨远端骨折患者术后营养状况和康复的影响

目的观察家庭主要照顾者实施回援法(Teach-back)干预对老年桡骨远端骨折患者术后营养状况和康复的影响。方法将2018年1-12月我院收治的80例老年桡骨远端骨折患者及其家庭主要照顾者随机分为观察组40例和对照组40例,观察组对主要照顾者实施Teach-back法健康教育,对照组给予主要照顾者常规健康教育。采用"桡骨远端骨折术后照顾者照顾能力调查问卷"评价照顾者照顾能力;微型营养评估量表(MNA)和传统营养指标评价患者术后营养状况;Gartland-Werley腕关节功能评分系统评价患者术后关节功能。结果观察组主要照顾者的照顾知识、照顾技能得分明显高于对照组,差异有统计学意义(P<0.05)。观察组患者人体测量、膳食评价、主观评价维度得分、MAN总分以及上臂肌围(TSF)、血清白蛋白(ALB)、前白蛋白(PA)明显高于对照组,差异有统计学意义(P<0.05)。术后2个月,观察组腕关节功能优良率为85.0%,对照组为77.5%,差异有统计学意义(Z=2.010,P=0.044)。结论对老年桡骨远端骨折患者家庭主要照顾者实施Teach-back,可以提高照顾者的照顾能力,改善患者营养状况,促进患者术后康复。     

基于回授法的多元化健康教育模式在泌尿外科腹腔镜手术患者健康教育中的应用

目的 探讨基于回授法的多元化健康教育模式在指导泌尿外科腹腔镜手术患者术后活动、有效咳嗽、咳痰,降低并发症的效果.方法 将2021年1月—5月期间于我院泌尿外科行腹腔镜手术治疗的120例患者随机分为干预组与对照组,每组各60例.对照组采用传统健康教育模式,干预组采用基于回授法的多元化健康教育模式;比较两组患者术后活动依从...     

Monthly communication skill coaching for healthcare staff

OBJECTIVE: To promote monthly interpersonal skill communication role-play and coaching for front-office staff. METHOD: For 15 min a month, during staff meetings, healthcare staff such as receptionists and medical assistants should participate in communication skill coaching. Participants should discuss a recurring communication challenge (e.g., patients irritated by repeated requests for health histories), role-play options for communication, and receive feedback. RESULT: Interpersonal communication skills such as acknowledging the concerns of others are acquired slowly. Repeated practice and supportive feedback increase the likelihood that these skills will be valued and mastered. CONCLUSION: Research shows communication skills develop when they are modeled and role-played frequently and are less likely to develop with occasional interventions. PRACTICE IMPLICATION: Health care professionals should devote time to role-playing interaction with patients for brief intervals at least monthly. Staff should give one another feedback on the best options for managing challenging communication situations.     

视频化健康教育联合回授法在脊柱外科手术患者中的应用效果

目的探讨视频化健康教育联合回授法在脊柱外科手术患者健康教育中的应用效果。 方法前瞻性收集2016年3月至6月西安交通大学附属红会医院脊柱外科住院患者206例,按照入院时间顺序分为对照组102例和干预组104例。对照组实施常规健康教育,干预组制作健康教育手册和视频,并运用回授法实施健康教育,通过问卷评价两组健康教育知识知晓率及患者对健康教育的满意度。 结果干预组（95.2%）患者健康知识知晓率显著高于对照组（78.4%,χ²=12.702,P<0.01）,且对健康教育的满意度（99%）亦高于对照组（93%）,差异有统计学意义（χ²=4.804,P<0.05）。 结论视频化健康教育联合回授法的健康教育效果优于常规的健康教育,而且患者的满意度高,值得推广。     

Relationship between Teach-back and patient-centered communication in primary care pediatric encounters

ObjectiveWe proposed and tested a theoretical framework for how use of Teach-back could influence communication during the pediatric clinical encounter.MethodsAudio-taped pediatric primary care encounters with 44 children with asthma were coded using the Roter Interaction Analysis System to measure patient-centered communication and affective engagement of the parent. A newly created Teach-back Loop Score measured the extent to which Teach-back occurred during the clinical encounter; parental health literacy was measured by Newest Vital Sign. Logistic regression was used to test the relationship between Teach-back and features of communication. Focus groups held separately with clinicians and parents elicited perceptions of Teach-back usefulness.ResultsTeach-back was used in 39% of encounters. Visits with Teach-back had more patient centered communication (p = 0.01). Adjusting for parent health literacy, parent age, and child age, Teach-back increased the odds of both patient centered communication [proportional AOR (95% CI) = 4.97 (4.47–5.53)]and negative affect [AOR (95% CI) = 5.39 (1.68–17.31)]. Focus group themes common to clinicians and parents included: Teach-back is effective, could cause discomfort, should be used with children, and nurses should use it.ConclusionsTeach-back was associated with more patient-centered communication and increased affective engagement of parents.Practice implicationsStandardizing Teach-back use may strengthen patient-centered communication.