發展進階護理師的癌症病情告知訓練

Development of Communication Skill Training on Cancer Truth Telling for Advanced Practice Nurses

10.3966/168395442016101603007

唐婉如(Woung-Ru Tang)

進階護理師 ； 病情告知 ； 癌症 ； 溝通技巧訓練 ； Advanced practice nurses ； Truth-telling ； Cancer ； Communication skill training

腫瘤護理雜誌

16卷增訂刊（2016 / 10 / 01）

87 - 97

繁體中文

病情告知是臨床常見且困難的工作項目，研究發現病人和家屬對病情告知的喜好與主治醫師實際的告知方式有很大的落差，在忙碌的醫療環境下，進階護理師（Advanced practice nurse, APN）特別是專科護理師（Nurse practitioner, NP）和個案管理師（Case manager, CM）是協助醫師提升告知品質的最佳人選。但目前國際間的癌症病情告知訓練模式，都是針對醫師角色所設計，礙於醫師角色有別於APN，若以訓練醫師的模式來教導APN，恐會導致日後臨床應用的困難，因此有必要透過實證，瞭解APN常見的告知困境、影響APN對癌症病情告知想法的因素，依其獨特的角色功能，在考量臨床情境下，發展出適合的癌症病情告知教育模式，才能透過溝通技巧訓練（Communication skill training, CST）來提升APN的告知能力與自信心，達到與醫師共同合作，提升癌症病情告知品質的目標。

Clinically, truth-telling is a common but difficult task. This study identified a huge gap between patients' and their family members' preferences for truth-telling and the actual practice of truth-telling of attending physicians. In the busy medical environment, advanced practice nurses (APNs), especially the nurse practitioners (NPs) and case managers (CMs) are the best candidates to assist doctors in improving truth-telling. However, the current international training models for truth-telling are designed for the physicians only. Because the role of doctors is different from that of APNs, applying the training models for doctors on APNs may lead to future difficulties in clinical practice. Therefore, it is necessary to deeper understand the common predicaments of truth-telling faced by APNs and the factors affecting their perceptions of cancer truth-telling while taking into account the clinical contexts to develop suitable cancer truth-telling education models according to their unique role functions. This way, Communication skill training (CST) can be used to improve APNs' ability and self-confidence in truth-telling to achieve effective collaboration with doctors for higher value of cancer truth-telling delivered.

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