针对糖尿病患者健康素养教育的社区医生医患沟通技能培训模式构建

A literacy-addressing training model to improve doctor-patient communication between com- munity heaithcare professional and patients with diabetes

我国糖尿病患者人数众多，健康素养水平低，其自我管理主要依靠社区医生的健康宣教，因此，培训社区医生的医患沟通技能极为重要。研究者以社会认知理论为指导，以健康素养为切入点，设计了一种全新的、以社区医生为培训对象、针对糖尿病患者的医患沟通培训模式。主要包括：①采用简单文字和图形，制作了一个传递核心保健信息的医患互动式工具包，供社区医生指导患者使用。②设立时长约5-6h的医患沟通培训标准课程，培训社区医生掌握工具包的使用、采用日常用语、使用“教回来”方式以及促进共同决策等医患沟通技巧。③使用模范医生和模拟病例，系统演示医患沟通全过程。④以慕课和微电影形式，将培训课程和医患沟通过程标准化、模式化。这种培训可作为继续教育项目，以课堂或远程教学方式进行；有望提高社区医生与患者的沟通能力，提升医患双方满意度和患者自我管理效果。

Diabetes patients in China is large in number, low level of health literacy, and their self management mainly relies on community doctor＇s health propaganda and education, as a result, it is very important to train community healthcare professionals to improve their communication skills with patients. Guided by the Social Cognitive Theory （SCT）, the researchers developed a literacy-ad- dressing training model specifically through： 1） low literacy heahhcare education materials written in plain language, simple text, maximal white space, and behavior-oriented images or pictograms; 2） a standardized health communication curriculum to promote simple communication with decreased jargon usage, teach ＂teach back＂, and enhance shared goal-setting; 3） use of standardized patients to enhance doctor-patient communication training; and 4） MOOC and a series of videos demonstrating doctor-pa- tient communication scenarios. The novel training model can be used in continuing medical education through traditional on-site classes or by E-learning platform. It is expected to improve the communi- cation skills of community doctors and patients, improve the satisfaction of both doctors and patients, and the effect of patients＇ self-management.