논문KCI 등재
To what Extent is the Role of Communication-skills Training Leading to Positive Outcomes in Primary Health Care? : A Systematic Review
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
주제분류의학일반
초록
Abstract
본문은 서구의 1차 의료기관에서 시행된 의료소통 훈련교육이 가져오는 긍정적 효과에 대해 체계적으로 검토하였다. 검토대상이 된 연구는 모두 유럽 및 북미 문화권에서 시행되었다. 대상 다섯 연구는 모두 RCT였으나 한 연구만 의료공급자와 환자측면 모두를 통제하였다. 임상의사소통 훈련교육은 의료공자 일인당 평균 13.5시간동안 진행되었고 핵심교육내용은 능동적 듣기 훈련, 환자의 질병인식, 환자입장에서 생각하기, 비언어 요소, 환자에게 질문할 기회제공 및 감정적 문제 다루기 등의 공통점이 발견되었다. 그러나 각 교육 프로그램마다 상이점 역시 존재하며, 교육 방법 및 매체 또한 상당히 넓은 폭을 보였다. 결과는 평균적으로 약 23.9%의긍정적 효과를 가져왔으며, 교육효과는 약 6~8개월 지속되는 것으로 분석되었다. 그러나 효과측정에 있어 주관적 지표가 필연적으로 포함되는바 측정의 정확도의 문제가 될 수 있으며, 나아가 객관적이라 할 수 있는 임상지표들은 대조군과 유의한 차이점을 보여주지 못했다. 이와 같은 연구결과는 의료인에 대한 의사소통 교육에 대한 긍정적 효과를 반영하지 못하므로, 의료공급자 및 환자 양쪽 측면을 모두 통제한 장기 관찰 연구가필요할 것이다.
참고문헌 (33)
- Koelewijn-van Loon MS, "Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial", CMAJ, 181(12), pp.E267~E274 (2009)
- McDonald DD, "Older adults' pain descriptions", Pain Manag Nurs, 10(3), pp.142~148 (2009)
- Cals JW, "Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial", BMJ, 338, pp.b1374~ (2009)[DOI]
- Young HN, "Physicians' shared decision-making behaviors in depression care", Arch Intern Med, 168(13), pp.1404~1408 (2008)
- Ommen O, "Trust, social support and patient type-associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients", Patient Educ Couns, 73(2), pp.196~204 (2008)
- Kocken PL, "Effects of health education for migrant females with psychosomatic complaints treated by general practitioners. A randomised controlled evaluation study", Patient Educ Couns, 70(1), pp.25~30 (2008)
- Qureshi NN, "Effect of general practitioner education on adherence to antihypertensive drugs: cluster randomised controlled trial", BMJ, 335(7628), pp.1030~ (2007)
- Liu JE, "Evaluation of an integrated communication skills training program for nurses in cancer care in Beijing, China", Nurs Res, 56(3), pp.202~209 (2007)
- Ammentorp J, "The effect of training in communication skills on medical doctors' and nurses' self-efficacy. A randomized controlled trial", Patient Educ Couns, 66(3), pp.270~277 (2007)
- Champion V, "The effect of telephone versus print tailoring for mammography adherence", Patient Educ Couns, 65(3), pp.416~423 (2007)
- Wetter DW, "Reaching and treating Spanish-speaking smokers through the National Cancer Institute's Cancer Information Service. A randomized controlled trial", Cancer, 109(2Supp), pp.406~413 (2007)
- Bieber C, "Longterm effects of a shared decision-making intervention on physician-patient interaction and outcome in fibromyalgia. A qualitative and quantitative 1 year follow-up of a randomized controlled trial", Patient Educ Couns, 63(3), pp.357~366 (2006)
- Schouten BC, "The impact of an intervention in intercultural communication on doctor-patient interaction in The Netherlands", Patient Educ Couns, 58(3), pp.288~295 (2005)
- McEwen A, "Triggering antismoking advice by GPs: mode of action of an intervention stimulating smoking cessation advice by GPs", Patient Educ Couns, 62(1), pp.89~94 (2006)
- Fagerlin A, "How making a risk estimate can change the feel of that risk: shifting attitudes toward breast cancer risk in a general public survey", Patient Educ Couns, 57(3), pp.294~299 (2005)
- Rosenthal MS, "A Randomized trial of practice-based education to improve delivery systems for anticipatory guidance", Arch Pediatr Adolesc Med, 159(5), pp.456~463 (2005)
- Verhoeven V, "A short educational intervention on communication skills improves the quality of screening for Chlamydia in GPs in Belgium: a cluster randomised controlled trial", Patient Educ Couns, 57(1), pp.101~105 (2005)
- Ornstein S, "A multimethod quality improvement intervention to improve preventive cardiovascular care: a cluster randomized trial", Ann Intern Med, 141(7), pp.523~532 (2004)
- Richards DA, "NHS Direct versus general practice based triage for same day appointments in primary care: cluster randomised controlled trial", BMJ, 329(7469), pp.774~ (2004)
- Heiman H, "Improving completion of advance directives in the primary care setting: a randomized controlled trial", Am J Med, 117(5), pp.318~324 (2004)
- Welschen I, "Effectiveness of a multiple intervention to reduce antibiotic prescribing for respiratory tract symptoms in primary care: randomised controlled trial", BMJ, 329(7463), pp.431~ (2004)
- Whelan T, "Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery:a randomized trial", JAMA, 292(4), pp.435~441 (2004)
- Wensing M, "Feedback based on patient evaluations: a tool for quality improvement?", Patient Educ Couns, 51(2), pp.149~153 (2003)
- Mørkved S, "Effect of adding biofeedback to pelvic floor muscle training to treat urodynamic stress incontinence", Obstet Gynecol, 100(4), pp.730~739 (2002)
- Frances CD, "Does a fixed physician reminder system improve the care of patients with coronary artery disease? A randomized controlled trial", West J Med, 175(3), pp.165~166 (2001)
- Lennox AS, "Cost effectiveness of computer tailored and non- tailored smoking cessation letters in general practice: randomised controlled trial", BMJ, 322(7299), pp.1396~ (2001)
- Eccles M, "Effect of audit and feedback, and reminder messages on primary-care radiology referrals: a randomised trial", Lancet, 357(9266), pp.1406~1409 (2001)
- Brown JB, "Effect of clinician communication skills training on patient satisfaction. A randomized, controlled trial", Ann Intern Med, 131(11), pp.822~829 (1999)
- Thompson F, "Overnight calls in primary care:randomised controlled trial of management using nurse telephone consultation", BMJ, 319(7222), pp.1408~ (1999)
- Jolly K, "Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina: final results of the Southampton heart integrated care project (SHIP)", BMJ, 318(7185), pp.706~711 (1999)
- O'Connell DL, "Randomised controlled trial of effect of feedback on general practitioners' prescribing in Australia", BMJ, 318(7182), pp.507~511 (1999)
- Kinmonth AL, "Randomised controlled trial of patient centred care of diabetes in general practice: impact on current wellbeing and future disease risk", BMJ, 317(7167), pp.1202~1208 (1998)
- Dexter PR, "Effectiveness of computer-generated reminders for increasing discussions about advance directives and completion of advance directive forms. A randomized, controlled trial", Ann Intern Med, 128(2), pp.102~110 (1998)
관련 논문AI추천
Assessing effective physician-patient communication skills: “Are you listening to me, doc?”Anthony C. Berman, Darryl S. Chutka한국의학교육학회 · Korean Journal of Medical Education2016 · 제28권 제2호Strengthening Primary Health Care through Medical EducationSeung-Won Oh대한가정의학회 · Korean Journal of Family Medicine2023 · 제44권 제4호How to Strengthen Primary Care? The Integration of Clinical Practice and Community Health CareErlina Wijayanti대한가정의학회 · Korean Journal of Family Medicine2024 · 제45권 제3호Unlocking the potential of primary care: addressing systemic challenges in chronic disease preventionJose Eric Mella Lacsa대한가정의학회 · Korean Journal of Family Medicine2025 · 제46권 제2호Shared Decision-Making Training in Family Medicine Residency: A Scoping ReviewApichai Wattanapisit, Eileen Nicolle, Savithiri Ratnapalan대한가정의학회 · Korean Journal of Family Medicine2024 · 제45권 제3호Standardized Patients or Conventional Lecture for Teaching Communication Skills to Undergraduate Medical Students: A Randomized Controlled StudyAlexy Tran Dinh, Henri Duboc, Hugo Peyre, Isabelle Etienne, Julie Delyon, Lara Zafrani, Marion Strullu, Michel Lejoyeux, Patrick Plaisance, Pierre A. Geoffroy, Pierre-François Ceccaldi대한신경정신의학회 · PSYCHIATRY INVESTIGATION2020 · 제17권 제4호
