Training Primary Care Physicians to Employ Self-Efficacy-Enhancing Interviewing Techniques: Randomized Controlled Trial of a Standardized Patient Intervention.
J Gen Intern Med
; 31(7): 716-22, 2016 07.
Article
em En
| MEDLINE
| ID: mdl-26956140
ABSTRACT
BACKGROUND:
Primary care providers (PCPs) have few tools for enhancing patient self-efficacy, a key mediator of myriad health-influencing behaviors.OBJECTIVE:
To examine whether brief standardized patient instructor (SPI)-delivered training increases PCPs' use of self-efficacy-enhancing interviewing techniques (SEE IT).DESIGN:
Randomized controlled trial.PARTICIPANTS:
Fifty-two family physicians and general internists from 12 primary care offices drawn from two health systems in Northern California.INTERVENTIONS:
Experimental arm PCPs received training in the use of SEE IT training during three outpatient SPI visits scheduled over a 1-month period. Control arm PCPs received a single SPI visit, during which they viewed a diabetes treatment video. All intervention visits (experimental and control) were timed to last 20 min. SPIs portrayed patients struggling with self-care of depression and diabetes in the first 7 min, then delivered the appropriate intervention content during the remaining 13 min. MAINMEASURES:
The primary outcome was provider use of SEE IT (a count of ten behaviors), coded from three audio-recorded standardized patient visits at 1-3 months, again involving depression and diabetes self-care. Two five-point scales measured physician responses to training Value (7 items quality, helpfulness, understandability, relevance, feasibility, planned use, care impact), and Hassle (2 items personal hassle, flow disruption). KEYRESULTS:
Pre-intervention, study PCPs used a mean of 0.7 behaviors/visit, with no significant between-arm difference (P = 0.23). Post-intervention, experimental arm PCPs used more of the behaviors than controls (mean 2.7 vs. 1.0 per visit; adjusted difference 1.7, 95 % CI 1.1-2.2; P < 0.001). Experimental arm PCPs had higher training Value scores than controls (mean difference 1.05, 95 % CI 0.68-1.42; P < 0.001), and similarly low Hassle scores.CONCLUSIONS:
Primary care physicians receiving brief SPI-delivered training increased their use of SEE IT and found the training to be of value. Whether patients visiting SEE IT-trained physicians experience improved health behaviors and outcomes warrants study. CLINICALTRIALS. GOV IDENTIFIER NCT01618552.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Comportamentos Relacionados com a Saúde
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Educação de Pacientes como Assunto
/
Entrevistas como Assunto
/
Autoeficácia
/
Médicos de Atenção Primária
Tipo de estudo:
Clinical_trials
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Prognostic_studies
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Qualitative_research
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Gen Intern Med
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Estados Unidos