scholarly journals The impact of training healthcare professionals’ communication skills on the clinical care of diabetes and hypertension: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mi Yao ◽  
Xue-ying Zhou ◽  
Zhi-jie Xu ◽  
Richard Lehman ◽  
Shamil Haroon ◽  
...  

Abstract Background Diabetes and hypertension care require effective communication between healthcare professionals and patients. Training programs may improve the communication skills of healthcare professionals but no systematic review has examined their effectiveness at improving clinical outcomes and patient experience in the context of diabetes and hypertension care. Methods We conducted a systematic review of randomized controlled trials to summarize the effectiveness of any type of communication skills training for healthcare professionals to improve diabetes and/or hypertension care compared to no training or usual care. We searched Medline, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform from inception to August 2020 without language restrictions. Data on the country, type of healthcare setting, type of healthcare professionals, population, intervention, comparison, primary outcomes of glycated hemoglobin (HbA1c) and blood pressure, and secondary outcomes of quality of life, patient experience and understanding, medication adherence and patient-doctor relationship were extracted for each included study. Risk of bias of included studies was assessed by Cochrane risk of bias tool. Results 7011 abstracts were identified, and 19 studies met the inclusion criteria. These included a total of 21,762 patients and 785 health professionals. 13 trials investigated the effect of communication skills training in diabetes management and 6 trials in hypertension. 10 trials were at a low risk and 9 trials were at a high risk of bias. Training included motivational interviewing, patient centred care communication, cardiovascular disease risk communication, shared decision making, cultural competency training and psychological skill training. The trials found no significant effects on HbA1c (n = 4501, pooled mean difference -0.02 mmol/mol, 95% CI -0.10 to 0.05), systolic blood pressure (n = 2505, pooled mean difference -2.61 mmHg, 95% CI -9.19 to 3.97), or diastolic blood pressure (n = 2440, pooled mean difference -0.06 mmHg, 95% CI -3.65 to 2.45). There was uncertainty in whether training was effective at improving secondary outcomes. Conclusion The communication skills training interventions for healthcare professionals identified in this systematic review did not improve HbA1c, BP or other relevant outcomes in patients with diabetes and hypertension. Further research is needed to methodically co-produce and evaluate communication skills training for chronic disease management with healthcare professionals and patients.

2019 ◽  
Vol 8 (1) ◽  
pp. 144
Author(s):  
Mojtaba Fattahi Ardakani ◽  
Mohammad Ali Morowati Sharifabad ◽  
Mohammad Amin Bahrami ◽  
Amin Salehi Abargouei

Author(s):  
Anne Finn ◽  
Emma King ◽  
Susie Wilkinson

This chapter describes the key challenges and rewards of the implementation and delivery of a programme of advanced communication skills training (ACST) for senior healthcare professionals working in cancer and palliative care in Northern Ireland (NI). It enables participants to reflect and critically appraise their own and others communication skills and to demonstrate the skills required to facilitate a structured patient-centred assessment/consultation using specific strategies to handle complex communication scenarios. Participants should also be able to tailor complex information to meet the needs of patients and carers. The course is based on an experiential, learner-centred approach, which is known to enhance effective person-centred communication and includes cognitive, behavioural, and affective components. A 2014 analysis of the programme recommends the two-day as opposed to the three-day model for ACST, as no disadvantages have been identified and this programme is better meeting the needs of the participants.


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025420 ◽  
Author(s):  
Mara Myrthe van Beusekom ◽  
Josie Cameron ◽  
Carolyn Bedi ◽  
Elspeth Banks ◽  
Gerald Humphris

ObjectivesMany cancer patients experience high levels of anxiety and concern during radiotherapy, often with long-lasting effects on their well-being. This systematic review aims to describe and determine the effectiveness of communication skills training (CST) for the radiotherapy team (RT) to improve conversations in this setting and to support patients with emotional concerns.DesignSystematic review.InterventionsCST for RT members.Data sourcesOn 17 April 2018, databases Medline, Embase, Scopus and PsycNET were searched.Eligibility criteria, Population, Intervention, Comparison, Outcome(PICO)Quantitative and/or qualitative articles were included that evaluate the effect of a CST for RT members (vs no CST) on communication behaviours and patients’ emotional concerns.Data extraction and synthesisArticles were appraised using the mixed-methods appraisal tool, and a narrative synthesis was performed.ResultsOf the nine included articles, five were randomised controlled trials, three were mixed-methods and one used repeated measurements. Four of the five different CST programmes managed to increase emotional communicative behaviour from the RT, and all studies measuring patient communicative behaviour found an improvement in at least one of the hypothesised outcomes. Two studies examining patient anxiety and concerns found a positive effect of the CST, although one found a negative effect; two other studies without a positive effect on mood made use of both empathic CST and tools.ConclusionsThere are promising indications that CST can be successfully introduced to improve emotional conversations between RT members and patients. With the right support, the RT can play an important role to help patients cope with their emotional concerns. Future work is necessary to confirm initial promising results and to ensure the learnt communication skills are sustained.


2017 ◽  
Vol 51 (7) ◽  
pp. 675-692 ◽  
Author(s):  
Philippa Ditton-Phare ◽  
Carmel Loughland ◽  
Robbert Duvivier ◽  
Brian Kelly

Objectives: A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. Methods: The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. Results: Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. Conclusion: The heterogeneity of communication skills training is a barrier to evaluating the efficacy of different communication skills training programmes. Further validation studies examining specific models and frameworks would support a stronger evidence base for communication skills training in psychiatry. It remains a challenge to develop research to investigate behaviour change over time in clinical practice or to measure patient outcomes due to the effects of communication skills training.


2015 ◽  
Vol 14 (4) ◽  
pp. 433-444 ◽  
Author(s):  
Laura Lord ◽  
David Clark-Carter ◽  
Amy Grove

AbstractObjective:A systematic review was conducted in order to explore the effectiveness of communication-skills training interventions in end-of-life care with noncancer acute-based healthcare staff.Method:Articles were included if they (1) focused on communication-skills training in end-of-life/palliative care for noncancer acute-based staff and (2) reported an outcome related to behavior change with regard to communication. Sixteen online databases were searched, which resulted in 4,038 potential articles. Screening of titles left 393 articles that met the inclusion criteria. Abstracts (n = 346) and full-text articles (n = 47) were reviewed, leaving 10 papers that met the criteria for our review. All articles explored the effect of communication-skills training on aspects of staff behavior; one study measured the effect on self-efficacy, another explored the impact on knowledge and competence, and another measured comfort levels in discussing the end of life with patients/families. Seven studies measured a number of outcomes, including confidence, attitude, preparedness, stress, and communication skills.Results:Few studies have focused on end-of-life communication-skills training in noncancer acute-based services. Those that do have report positive effects on staff behavior with regard to communication about the end of life with patients and families. The studies varied in terms of the population studied and the health services involved, and they scored only moderately or weakly on quality. It is a challenge to draw a definite conclusion about the effectiveness of training interventions in end-of-life communication because of this. However, the findings from our review demonstrate the potential effectiveness of a range of training interventions with healthcare professionals on confidence, attitude, self-efficacy, and communication skills.Significance of results:Further research is needed to fully explore the effectiveness of existing training interventions in this population, and evidence using objective measures is particularly needed. Ideally, randomized controlled trials or studies using control groups and longer follow-ups are needed to test the effectiveness of interventions.


2011 ◽  
Vol 9 (4) ◽  
pp. 359-365 ◽  
Author(s):  
Philip A. Bialer ◽  
David Kissane ◽  
Richard Brown ◽  
Tomer Levin ◽  
Carma Bylund

AbstractObjective:The purpose of this study was to develop a communication skills training (CST) module for oncology healthcare professionals on how to more effectively respond to patient anger. We also sought to evaluate the module in terms of participant self-efficacy and satisfaction.Method:The development of this module was based on a systematic review of the literature and followed the Comskil model previously used for other doctor–patient CST. Using an anonymous 5-point Likert scale, participants rated their pre-post self-efficacy in responding to patient anger as well as their satisfaction with the course. Data were analyzed using a paired sample t test.Results:During the academic years 2006–2009, 275 oncology healthcare professionals participated in a CST that focused on responding to patient anger. Participants' confidence in responding to patient anger increased significantly (p < 0.001) after attending the workshop. They also agreed or strongly agreed to five out of six items assessing course satisfaction 92–97% of the time.Significance of results:We have developed a CST module on how to respond to patient anger, which is both effective and useful. Training healthcare professionals to respond more effectively to patient anger may have a positive impact on the patient–physician relationship.


2020 ◽  
Author(s):  
Haonan Tian ◽  
Congman Xie ◽  
Min Lin ◽  
Hongmei Yang ◽  
Aishu Ren

Abstract Background: Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods: A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs) . The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean difference s and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results: Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1. 56 mm , 95% CI: 1.14 to 1.98, P <0.00001 ) and the mandible (1.62 mm , 95% CI: 1.24 to 2.01, P <0.00001 ) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm , 95% CI: 0.16 to 0.69, P =0.001 ) and the mandible (0.26 mm , 95% CI: 0.02 to 0.49, P =0.03 ). Conclusions: There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed. Keywords: Orthodontic implants; Canine retraction; Systematic review; Meta-analysis


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