提高医生告知坏消息的技能——两种常用沟通模式

Improving Doctors' Skills for Breaking Bad News:Two Commonly Used Communication Models

医生、医学生都对告知坏消息感到压力大,没有统一的标准和固定的模式讲述如何告知坏消息,是坏消息难于告知的重要原因。在国外,对于坏消息的告知,最为常用的两种沟通模式是SPIKES模式和ABCDE模式。这两种模式均描述了有效传递坏消息的程序和步骤,并强调了告知坏消息中的关键点,包括对病人同情心的表达,认可病人的情感,了解病人对坏消息的理解及接受情况,为进一步的治疗提供信息等。介绍了这两种沟通模式及其教学方法,为医学院校病情告知技能相关内容的课程教学提供参考。

Doctors as well as medical students consistently report that breaking bad news is stressful. Lacking general guideline and model regarding breaking bad news are the important reasons for the difficulty in breaking bad news. In abroad, the two commonly used communication models for breaking bad news are the SPIKES model and ABCDE model. This two models both describe the process for effectively breaking bad news, and stress the key points during breaking bad news including expressing empathy to the patients, encouraging and validating patients ＇ emotions, learning about patients ＇ perception and reaction to the bad news, telling patients the information about their further treatment and so on. This article described these two models and their teaching methods in detail to provide information for the teaching related to improving the medical students＇ skills of breaking bad news in medical school.