护理人员预立医疗照护计划的沟通培训

Communication training on advance care planning for nurses

目的提升护理人员对预立医疗照护计划(ACP)的认知,促进ACP的顺利实施。方法基于Comskil沟通模式和ACP理论模型及系统文献回顾,制订ACP相关培训内容和培训形式,并借助“杏林晚语”视频、ACP知识教育册子、我的晚期生活册子等对110名临床护理人员进行ACP沟通培训。于培训前后评估护理人员的ACP认知、态度及自我效能。结果培训后护理人员对ACP认知正确率均有所提高,且培训后ACP沟通内容和实现治疗意愿被尊重2个条目的正确率显著提高(P<0.05,P<0.01)。护理人员对ACP态度中2个条目得分培训前后差异有统计学意义(均P<0.05);自我效能有6个条目得分培训前后差异有统计学意义(P<0.05,P<0.01)。结论对护理人员进行ACP沟通培训在一定程度可提升其对ACP的认知,促进ACP态度的正向改变,有利于推进临床护理中ACP工作的开展。

Objective To enhance nurses′cognition on Advance Care Planning(ACP),and to improve the implementation of ACP.Methods The ACP related training contents and forms were designed based on the Comskil Communication Model,ACP Theoretical Model and systematic literature review,then 110 nurses received ACP communication training through"Xinglin Wan Yu"video,ACP knowledge education booklet,"my end-of life"booklet,etc.The nurses′knowledge,attitude and self-efficacy on ACP were assessed before and after the training.Results After the training,the nurses′accuracy rate on ACP cognition improved,and the accuracy rate for two items(ACP communication contents and realizing treatment preferences will be respected)improved significantly when compared with those before the training(P<0.05,P<0.01).The scores of nurses′attitude towards ACP decreased,and two items decreased significantly(P<0.05 for both),and six items of self-efficacy scored significantly different before and after the training(P<0.05,P<0.01).Conclusion Conducting ACP communication training for nurses can enhance their cognition on ACP to some extent,improve their attitude towards ACP changing positively,thus it is conducive to pushing ACP implementation in clinical nursing.